Does your new medical technology meet the coverage requirements of government and private health insurers? NAMSA can help you open doors for coverage.
Reimbursement Strategies conducts Medical Policy Research and Coverage Advocacy to provide companies with insight into the probable coverage status of new and emerging technologies among government and private health insurers around the globe.
Most Medicare coverage determinations are made among the Medical Administrative Contractors who serve ten (10) different jurisdictions. Coverage for products and services can vary widely among these administrators, even though they all administer the same Medicare benefits. Private insurer medical coverage policy varies widely throughout the country. Medical policy research and analysis is a critical component of any product business risk evaluation.
When medical coverage policies do not cover such technologies, or do not exist, NAMSA’s experts will meet with health plan medical policy makers to advocate for change. Most private payers are unwilling to meet directly with manufacturers, but will make accommodations for third party representation among consultants they trust. Medical Science Liaisons (MSLs) are thoroughly vetted health care professionals who engage in peer-to-peer discussions with clinicians, nurses, payers, and key opinion leaders on behalf of clients, ensuring an appropriate, compliant and comprehensive exchange of information regarding medical products. Responsibilities include education of KOLs, physicians, health plan medical policy leaders and others throughout a product’s lifecycle, including support in conjunction with the launch or approval of an expanded indication, new pharmaceutical product or medical device.
A Clinical Dossier is a marketing tool targeted to the specific interests and concerns of payers and is frequently required to secure government and private payer coverage. Payers have different motivations as compared to hospitals, physicians or patients. NAMSA understands this and creates clinical dossiers to address their concerns related to key attributes about the medical product or service, clinical indications for use, mechanism of operation, supporting technology, literature reviews, cost effectiveness, and prevalence of the disease condition for which the product is targeted.