Prescription Digital Therapeutics
The Access to Prescription Digital Therapeutics Act of 2022 (S. 3791/H.R. 7051) is an important bipartisan bill that will improve care for millions of Americans by expanding coverage of prescription digital therapeutics (PDTs). PDTs are software-based therapies that deliver a clinical benefit to patients, either alone or in combination with other treatments. However, they do not currently fit into one of the statutorily defined coverage categories for the Medicare or Medicaid programs. This leaves beneficiaries of those programs, which include some of America’s most vulnerable populations, without access to these cost-effective and accessible treatments. Previous regulatory efforts to expand Medicare and Medicaid coverage of PDTs have been ineffective at improving access for patients. This bill will add PDTs to the list of services and products eligible for coverage under Medicare and Medicaid, as well as direct the Centers for Medicare & Medicaid Services (CMS) to establish payment methodologies and product-specific Healthcare Common Procedure Coding System (HCPCS) codes.
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