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Orthopaedic Industry Must Respond to Payor Denial of Implant Coverage

Orthopaedic device manufacturers have long battled the regulatory landscape to product approval. But, “FDA [regulatory] approval doesn’t equal insurance [payor] approval,” surgeon entrepreneur and inventor Robert S. Bray, Jr., M.D., reminded industry during his keynote address at OMTEC®, the 10th Annual Orthopaedic Manufacturing & Technology Exposition and Conference.

Payor denial of procedures and products lacking long-term data are expected to escalate as both industry and government-sponsored payor systems scrutinize spend to support and comply with the Affordable Care Act. Bray’s keynote remarks echo observations offered in 2011 by veteran OMTEC speaker Kelli Hallas, when she urged attendees to integrate reimbursement strategy at the development phase and offered a ten-step checklist to aid in the process. “Even some of the most promising technologies have failed because of lack of reimbursement,” cautioned Ms. Hallas.

Founded in 2005, OMTEC is recognized as an international conference that provides orthopaedic industry professionals the tools and partnerships needed to improve performance. OMTEC 2014 speaker presentations and 2015 event updates are available at www.OMTECexpo.com. Industry is encouraged to save the dates of June 17-18 for the 2015 event in Chicago, Illinois.