Favorable Decision for ACR Members in “TMA III” NSA Case
Fifth Circuit ruling on No Surprises Act QPA calculations supports fair physician reimbursement and stronger insurer accountability.
Read moreACR® with the Society of Interventional Radiology, Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions and Outpatient Endovascular and Interventional Society submitted a public comment to Washington State Health Care Authority (HCA) regarding its draft evidence report about balloon angioplasty and stenting for lower extremity peripheral arterial disease (PAD). The associations urge the Washington State Health Technology Clinical Committee (HTCC) to not act on the draft report that would, as written, limit coverage of endovascular procedures for PAD. Additionally, the analysis in the draft report includes, and does not differentiate, intermittent claudication (IC) from chronic limb-threatening ischemia (CLTI) in the patient population and in the literature review.
HTCC has the authority to change or stop coverage for certain endovascular procedures, affecting about 2.3 million Washington residents — nearly 30% of the state’s population. These decisions could significantly impact patients whose care is covered by the State Employee Health Plan, Medicaid or Workers’ Compensation programs.
HCA published a draft evidence report for public comment and is expected to publish the final evidence report Aug. 15. A public meeting will be held Sept. 19, where physicians will present to the Washington HCA to discuss the evidence report before a coverage decision is made. The draft findings and decision will be published Sept. 29.
For more information or questions, contact Alicia Blakey, ACR Principal Economic Policy Analyst.
Favorable Decision for ACR Members in “TMA III” NSA Case
Fifth Circuit ruling on No Surprises Act QPA calculations supports fair physician reimbursement and stronger insurer accountability.
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CMS finalized FY 2027 hospital payment updates, including a 2.3% increase, new technology payments and AI-related policy changes.
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