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Cures 2.0 Bill Could Push Plans to Cover More New Devices

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What You Need to Know

  • The bill is a sequel to the popular 21st Century Cures Act bill.
  • One section could create a big, flexible, medical research version of DARPA.
  • Another section would update Medicare telehealth coverage rules.

Two House members are trying to use people’s common fear of illness to bring Americans closer together.

Reps. Diana DeGette, D-Colo., and Fred Upton, R-Mich., have teamed up to release a sequel to their popular 2016 health care finance bill, which created the 21st Century Cures Act of 2016.

The new “21st Century Cures 2.0″ bill, which at deadline did not have a bill tracking number, would fund many efforts to support health research, develop new treatments and push Medicare to cover innovative forms of care.

DeGette and Upton emphasized in a comment included in the bill unveiling announcement that they believe the bill is bipartisan.

“Diseases such as cancer, diabetes, Alzheimer’s and ALS don’t care if you’re a Democrat or Republican,” DeGette and Upton said. “They affect all of us the same.”

For financial professionals who help clients with matters such as health insurance, health care cost planning and long-term care planning, the introduction of the bill could mean more emotional discussions about which medical innovations are worth their cost, and how clients and society can put a price on an extra day, month or year of pain-free life.

DARPA, but for Health Tech

One of the key provisions in the bill would create an Advanced Research Projects for Health, or ARPA-H, which would be a small, flexible research funding agency inside the National Institutes of Health.

DeGette and Upton say they hope ARPA-H, which would come to life with $6.5 billion in funding for a period of three years, would do for health technology research what the Defense Advanced Research Projects Agency, or DARPA, has done for technology in general.

DARPA is an arm of the Department of Defense that has funded some of the work that led to the creation of the Internet, GPS devices and self-driving cars.

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Medicare Sections

The Cures 2.0 bill would not directly influence commercial health coverage, but it could influence coverage indirectly, by pushing managers of Medicare to change Medicare coverage rules.

Because Medicare is so big and influential, changes in its rules often affect commercial carriers’ coverage decisions.

Here are some of the sections could affect Medicare benefits:

Section 205: This section would let Medicare pay enrollees’ claims when the enrollees were getting care through some federally funded care effectiveness clinical trials. Normally, Medicare and commercial insurers do not pay for care for patients involved in clinical trials.

Section 403: Medicare managers have loosened telehealth coverage rules in response to the COVID-19 pandemic. This section would make the telehealth coverage rule changes permanent.

Section 404: This succession would ease Medicare rules for coverage for “critical breakthrough” medical devices.

Section 408: This section would provide for Medicare to pay for visits with genetic counselors and clinical pharmacists, to help patients determine how their genes might affect which drugs they should use.

Section 411: This section would give researchers access to registries that connect Medicare claim data with clinical data.

Pictured: Rep. Diana DeGette (Photo: DeGette)