Decisions about medical coverage by Medicare specify the formsof technology and services that the program will pay for onbehalf of its 42 million beneficiaries. These decisions oftenhave far-reaching effects through their influence on the policiesof other public and private payers in determining medical necessity.For the nearly four decades since Medicare was created in 1965,coverage decisions have been based on section 1862(a)(1)(A)of the statute that enacted the program: "Notwithstanding anyother provision of this title, no payment may be made . . .for any expenses incurred for items or services which . . . . . [Full Text of this Article]
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From the Office of Clinical Standards and Quality, Centers for Medicare and Medicaid Services, Baltimore.
Otero, H. J., Rybicki, F. J., Greenberg, D., Neumann, P. J.
(2008). Twenty Years of Cost-effectiveness Analysis in Medical Imaging: Are We Improving?. Radiology
249: 917-925
[Abstract][Full Text]
American College of Physicians,
(2008). Information on Cost-Effectiveness: An Essential Product of a National Comparative Effectiveness Program. ANN INTERN MED
148: 956-961
[Abstract][Full Text]
Hoffman, J. M., Gambhir, S. S., Kelloff, G. J.
(2007). Regulatory and Reimbursement Challenges for Molecular Imaging. Radiology
245: 645-660
[Abstract][Full Text]
Gold, M. R., Sofaer, S., Siegelberg, T.
(2007). Medicare And Cost-Effectiveness Analysis: Time To Ask The Taxpayers. Health Aff (Millwood)
26: 1399-1406
[Abstract][Full Text]
Meropol, N. J., Schulman, K. A.
(2007). Cost of Cancer Care: Issues and Implications. JCO
25: 180-186
[Abstract][Full Text]
Groeneveld, P. W.
(2006). Medicare Requirement for Research Participation. JAMA
296: 2923-2924
[Full Text]
Pearson, S. D., Miller, F. G., Emanuel, E. J.
(2006). Medicare's requirement for research participation as a condition of coverage: is it ethical?. JAMA
296: 988-991
[Full Text]
Pearson, S. D., Rawlins, M. D.
(2005). Quality, Innovation, and Value for Money: NICE and the British National Health Service. JAMA
294: 2618-2622
[Abstract][Full Text]
Neumann, P. J., Rosen, A. B., Weinstein, M. C.
(2005). Medicare and Cost-Effectiveness Analysis. NEJM
353: 1516-1522
[Full Text]
Kadish, A., Mehra, M.
(2005). Heart Failure Devices: Implantable Cardioverter-Defibrillators and Biventricular Pacing Therapy. Circulation
111: 3327-3335
[Full Text]
Califf, R. M.
(2005). Simple Principles of Clinical Trials Remain Powerful. JAMA
293: 489-491
[Full Text]
Hlatky, M. A., Sanders, G. D., Owens, D. K.
(2005). Evidence-Based Medicine And Policy: The Case Of The Implantable Cardioverter Defibrillator. Health Aff (Millwood)
24: 42-51
[Abstract][Full Text]
Ramsey, S. D., Sullivan, S. D.
(2005). Evidence, Economics, And Emphysema: Medicare's Long Journey With Lung Volume Reduction Surgery. Health Aff (Millwood)
24: 55-66
[Abstract][Full Text]
Mendelson, D., Carino, T. V.
(2005). Evidence-Based Medicine In The United States--De Rigueur Or Dream Deferred?. Health Aff (Millwood)
24: 133-136
[Abstract][Full Text]
Clancy, C. M., Cronin, K.
(2005). Evidence-Based Decision Making: Global Evidence, Local Decisions. Health Aff (Millwood)
24: 151-162
[Abstract][Full Text]
Califf, R. M., Ryan, T., Douglas, P., Goldschmidt-Clermont, P. J.
(2004). A time of accelerated change in academic cardiovascular medicine: Implications for academic divisions of cardiology and their training programs. J Am Coll Cardiol
44: 1957-1965
[Abstract][Full Text]
Wynia, M. K., Witlen, R., Hart, S., Gillick, M. R., Tunis, S. R.
(2004). Medicare Coverage for Technological Innovations. NEJM
351: 719-720
[Full Text]