MedPAC held a meeting on November 2-3, 2023 (link). The following relevant topics were discussed:

Medicare coverage of and payment for software as a medical service: An overview
Evaluating access in Medicare Advantage: Network management and prior authorization

ADVI Angle

Key takeaways from the November meeting include:

Medicare coverage of and payment for software as a medical service: An overview
MedPAC staff provided an overview of current Medicare payment and coverage for software as a medical service (SaMS) and suggested areas for Commissioner discussion.
Commissioners largely agreed that:
It would be useful to track SaMS utilization
Payment for SaMS:
Should incentivize the development of devices that reduce costs
Is preferable through bundles vs fee-for-service
Should be structured to avoid induced demand
The new-technology add-on payment (NTAP) may incentivize higher priced products.
Evaluating access in Medicare Advantage: Network management and prior authorization
MedPAC staff provided an overview of network management and prior authorization (PA) in Medicare Advantage (MA).
Commissioners largely agreed that:
While PA is not always a bad thing, there are issues with its use in MA
Data points such as network adequacy, denial rates, and use of out-of-network care should be included in public measures such as Star Ratings. 
Outdated provider directories are “completely unacceptable” and harm beneficiaries

This is an abridged and delayed release. Full ADVI Analysis content is distributed in real time for retainer clients. Get in touch to learn more about how we can support your commercialization, market access, and policy needs.