Congressional Hearing Advances Medicare Coverage for Breakthrough Medical Technologies

A recent legislative hearing led by Congressman Morgan Griffith focused on improving seniors' access to breakthrough medical technologies through Medicare. The discussions addressed reducing regulatory barriers and increasing transparency in coverage decisions by the Centers for Medicare & Medicaid Services (CMS). Key issues highlighted include accelerating coverage pathways for innovative therapies and advanced medical devices that currently face delays in CMS approval, known as the 'valley of death.' The hearing also emphasized the potential impact of new policies, such as the Ensuring Patient Access to Critical Breakthrough Products Act of 2025, which aims to modernize Medicare coverage frameworks to keep pace with medical innovation.

Several representatives underscored the importance of timely access to advanced healthcare technologies for Medicare beneficiaries, especially for conditions like cardiovascular disorders and cancer. The Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act was discussed as a pivotal measure to grant CMS authority to cover multi-cancer early detection tests post-FDA approval, aiming to improve early diagnosis and reduce treatment burdens for late-stage cancers.

This legislative focus reflects ongoing efforts to address challenges within Medicare's coverage determination processes, including the use of Transitional Coverage for Emerging Technologies and Coverage with Evidence Development (CED) policies. The hearing highlighted the need for expanded and accelerated mechanisms to ensure that breakthrough technologies reach seniors promptly, addressing both clinical and economic impacts.

Overall, the hearing represents a strategic examination of Medicare policies to better align them with the rapid pace of medical technology development. By streamlining coverage decisions and enhancing transparency, policymakers seek to improve healthcare outcomes for seniors while navigating regulatory complexities.