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www.fdanews.com/articles/147444-report-physician-owned-entities-could-reduce-device-implant-prices

Report: Physician-Owned Entities Could Reduce Device Implant Prices

June 22, 2012

Allowing physician-owned entities to purchase surgical implants lowers costs and improves pricing transparency if done correctly, a legal expert maintains. But federal guidance is needed to ensure such businesses comply with Medicare pricing and reimbursement policy.

Writing in the May 23 issue of Food & Drug Policy Forum, Joseph Truhe, senior vice president and general counsel at PDP Holdings in Nashville, Tenn., says guidance could help explain how physician-owned entities might be structured and what features might lead to fraud. At the same time, Congress and the Centers for Medicare & Medicaid Services should work on reforms to make surgical implant pricing more transparent, such as barring confidentiality provisions that prevent negotiation.

The U.S. healthcare system once rewarded (and paid for) performing individual procedures; now it is evolving toward a system that will penalize (over)utilization and instead reward efficiency, delivering quality health outcomes and producing measurable cost savings.

Whether the Supreme Court strikes down part or all of the Affordable Care Act, or decides to leave the law unchanged, securing profitable coverage, unique coding and appropriate, value-based payment for medical devices and diagnostics will continue.

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