Healthcare Policy and Opinion

America has the providers, the science, the drugs, the diagnostics, and the devices needed for outstanding patient care. But the delivery of care is dysfunctional at best and far too expensive.

“Investigational” Is Payer Code for “Coverage Denied”

Gil Bashe, Medika Life Editor - February 18, 2021

Outside the pandemic, “investigational” remains payer code for denying reimbursement. In the case of treatment for chronic conditions, even FDA-approved digital-health and connected devices languish on waitlists for formulary inclusion.

Nonsensical Processes Prevent Patient Access to New and Safe Treatments

Dr Jeff Livingston - February 18, 2021

Health technological innovations only have value if doctors and patients have access to them. Insurance companies label new products as investigational to justify the denial of care.

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