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Contact:
Mark E. Brager
202-434-7244
mbrager@advamed.org
March 26, 2014

AdvaMed Statement on SGR Legislation

WASHINGTON, D.C. – The Advanced Medical Technology Association (AdvaMed) released the following statement by JC Scott, senior executive vice president, government affairs, on the bipartisan legislation introduced to repeal the Medicare sustainable growth-rate (SGR) formula:

“AdvaMed supports provisions in the SGR legislation which will modernize the clinical lab fee schedule and recognize the value of diagnostics to health care outcomes.

“Diagnostic tests are critical to modern health care, impacting patients at all stages of care – from initial diagnosis and treatment to prognosis and follow up. Unfortunately, innovative new technologies are being reimbursed under Medicare’s flawed and outdated Clinical Laboratory Fee Schedule, stifling investment and further progress in new tests that are crucial to patient care.

“The changes included in the SGR legislation will modernize Medicare’s current reimbursement system for diagnostics by creating a more transparent process for appropriately valuing new tests and ensuring timely patient access.

“AdvaMed also is pleased with the imaging provisions of the SGR bill, which require ordering physicians to consult physician-developed appropriate use criteria for advanced imaging services. We believe this will encourage further patient access to medical imaging, which is a vital tool in the early detection and treatment of so many conditions.

“We are disappointed that the legislation includes a further delay of the ICD-10 procedure coding system. ICD-10 is the next generation coding system that will modernize and expand the capacity of public and private payers to keep pace with changes in medical practice and health care delivery. New and innovative medical technologies have been living under a code freeze under the limitations of ICD-9. It makes no sense to delay something that will provide higher quality information for measuring service quality, outcomes, safety, and efficiency.

“Finally, we are reviewing the bill’s provision which would expand the list of criteria HHS can use to identify potentially mis-valued services to determine if patient access to needed office-based procedures would be negatively impacted.

“We look forward to working with members of Congress and other stakeholders as the SGR legislation moves forward.”

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AdvaMed member companies produce the medical devices, diagnostic products and health information systems that are transforming health care through earlier disease detection, less invasive procedures and more effective treatments. AdvaMed members range from the largest to the smallest medical technology innovators and companies. For more information, visit www.advamed.org.