Reimbursement & Market Access
173 articles
Australia Prescribed List: Device Reimbursement Tiers, Fees and Benefit Reform
Complete guide to the Australia Prescribed List (formerly Prostheses List), covering application tiers, HPA pathways, 2026-27 cost recovery fees, benefit reductions, and post-listing review.
Medicare IPPS and MS-DRGs for Medical Devices: Inpatient Payment Guide
Guide to Medicare IPPS and MS-DRGs for medical devices, covering inpatient payment calculation, NTAP add-on payments, and the FY2027 Breakthrough overhaul.
China Volume-Based Procurement (VBP) for Medical Devices: Price Cuts & Strategy
Guide to China's NHSA volume-based procurement (VBP) for medical devices: round history, price cuts, provincial alliances, and multinational strategy.
FDA TAP Pilot Program Guide: Total Product Life Cycle Advisory Strategy
Guide to FDA CDRH Total Product Life Cycle Advisory (TAP) Pilot Program, Breakthrough Device eligibility, 14-day advisor meetings, and CMS payor alignment.
Commercial Insurance Coverage for Medical Devices: Payer Policy and Prior Auth
Guide to US commercial and private-payer coverage for medical devices — medical policy, prior authorization, ERISA self-funded plans, appeals, and the Medicare NCD/LCD benchmark.
Medicare CLFS Under PAMA: What IVD & Diagnostic Developers Must Know in 2026
Comprehensive 2026 guide to Medicare CLFS lab payment under PAMA: applicable lab rules, 3-year CDLT cycle, ADLT status, gapfilling, and CAA 2026 Section 6226 updates.
Medicare OPPS Device Pass-Through: CY2026 Categories and Criteria
A guide to Medicare OPPS transitional pass-through device payments, covering CY2026 categories, 42 CFR 419.66 criteria, and the FDA Breakthrough pathway.
DMEPOS Prior Authorization for Devices: Master, Required & the 2026 Exemption
A comprehensive guide to traditional Medicare DMEPOS prior authorization. Understand the Master and Required lists, the 2026 updates, and the 90% supplier exemption.
Medicare Advantage Prior Authorization for Medical Devices: Navigating the 2026 Rules
A comprehensive guide to Medicare Advantage prior authorization for medical devices. Learn about CMS-0057-F timelines, CY2026 rules, denial rates, and appeal strategies.
Medicare Coverage with Evidence Development (CED) for Medical Devices
A comprehensive guide to Medicare Coverage with Evidence Development (CED) in 2026, mapping active device NCDs, study and registry requirements, and the graduation timeline.
Bundled Payments for Medical Devices: BPCI-Advanced, CJR & Implant Pricing
A strategic playbook for medical device companies navigating CMS bundled payment models (BPCI-Advanced, CJR). Dissects implant pricing and NTAP/OPPS exclusions.
Outcomes-Based & Value-Based Contracts for Medical Devices: Commercial Playbook
A comprehensive guide to structuring outcomes-based and value-based contracts for medical devices. Analyzes OIG safe harbors, Stark Law, metrics, and case studies.
Certificate of Need (CON) for Medical Devices: State-by-State Guide
State-by-state guide to Certificate of Need (CON) rules for capital medical devices. Map reviewable equipment, thresholds, and sales strategy.
Hospital Value Analysis Committees and GPOs: How US Medical Devices Get Bought
Playbook on US hospital Value Analysis Committees (VAC) and Group Purchasing Organizations (GPOs). Explains evaluation rubrics and contracting pathways.
HEOR and the Global Value Dossier: Building Device Evidence That Wins Reimbursement
A guide to HEOR and Global Value Dossier strategy for medical devices. Dissects device-specific economic modeling and payer evidence requirements.
Burundi Essential Medical Devices List Teardown: ABREMA 2025
A data-driven teardown of Burundi's National Essential Medical Devices List (2025). Analyze the risk-class split, clinical-service mix, WHO-style tomes, and ABREMA legal framework.
DR Congo ACOREP Register: China's 51% Share and Local Agent Lock-in
A quantitative teardown of the DR Congo medical device register under ACOREP, analyzing import dependency, local agent concentration, and product categories.
Lebanon MoPH Authorized Implantable Medical Devices Teardown
A detailed analysis of Lebanon's Ministry of Public Health implantable medical device register under Decree 455/1, examining risk classes, manufacturers, and supplier dynamics.
Why FDA or CE Clearances Fail to Register Aesthetic Devices in China, Korea, and Brazil
A deep regulatory analysis of aesthetic device classification and registration pathway divergence across the US, EU, China, South Korea, and Brazil, mapping sequencing strategies and all-in costs.
Bangladesh DGDA Registered Medical Devices Teardown: Chinese IVDs & Class C Majority
A data-driven teardown of Bangladesh's Directorate General of Drug Administration (DGDA) registered medical device list, analyzing risk classes, manufacturers, and importers.