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WASHINGTON
(AP) -- Chicago spinal surgeon Stephen Ondra tries to keep his elderly
patients mobile, but he says outdated Medicare rules are preventing him
from getting new technology for them.
Some
lawmakers want to address the problem with legislation to reduce the time
it takes to get new technologies covered by Medicare.
``We
have a population that's living longer and aging and still wants to be
active,'' Ondra said. ``These are healthy people that would lead active
lives for a long time, so there's a big return on the investment.''
Unfortunately,
Ondra said, ``We're losing so much money on Medicare patients we can't
deliver that care.''
Reps.
Anna Eshoo, D-Calif., and Jim Ramstad, R-Minn., hope the bill they are
introducing Wednesday will modernize the 38-year-old program to keep pace
with changing health technology.
The
legislation would make a number of regulatory changes to speed new medical
treatments to patients, including six- to 12-month deadlines for Medicare
to implement coverage and payment for new technologies. It would also
create a Council for Technology and Innovation to improve coordination of
coverage and payment decisions for new technologies.
Medicare
would also be directed to provide reimbursement for routine costs of care
incurred by the elderly while participating in clinical trials that
involve breakthrough technologies like artificial hearts or bionic eyes.
The
bill also would order the Medicare agency to develop a better system for
appeals of claims denials. Currently Medicare patients appealing claims
decisions wait months -- sometimes longer than a year -- to have an appeal
heard.
Eshoo
said the legislation would ``make things happen'' in the area of
innovative treatments. She cited the reimbursements for elderly patients
participating in clinical trials as key.
``It's
very difficult to do testing on the elderly. It's a different kind of
population. The risks can run higher and when the reimbursement is not
there it gets to be kind of hands-off,'' Eshoo said. ``This bill would
change all of that.''
Ondra
said improved coverage of the new technologies would make a difference in
his medical practice.
For
instance, he has been unable to get Medicare to pay for the infusion bone
graft device, which was approved by the Food and Drug Administration last
year for certain back pain sufferers. The device contains a genetically
engineered protein that eliminates the need from a hip graft, where bone
is culled from a patient's hip to use in spinal surgery.
The
newer technology, which costs about $3,000 a dose, ``will give us the same
result without the morbidity to the patient,'' Ondra said, adding that
there is less discomfort and potential for infection.
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