Sens. Shelley Moore Capito, R-W.Va, and Jeanne Shaheen, D-N.H., have reintroduced a bill that would expand access to software-based treatments and create a reimbursement pathway for software that treats medical conditions.
The Access to Prescription Digital Therapeutics Act of 2023, originally introduced about two years ago, attempts to address the Medicare program's lack of authority to cover digital therapeutics technologies under its current benefit categories.
It would do so by creating an entirely new category for prescription digital therapeutics that have been approved by the Food and Drug Administration and cleared for use among Medicare seniors.
WHAT'S THE IMPACT
Prescription digital therapeutics (PDTs) are designed and tested much like traditional prescription drugs, but rather than swallowing a pill or taking an injection, patients receive cognitive therapy through software.
The treatments are tested for safety and efficacy in randomized clinical trials, evaluated by the FDA and prescribed by healthcare providers.
"Prescription Digital Therapeutics are tested and regulated like traditional prescription medication, so it's common sense that we remove barriers to care for those who respond positively to this kind of treatment," said Shaheen at the time of the bill's original introduction. "Prescription digital therapeutics can help treat a range of diseases, including substance use disorders and mental health challenges, but many who need this treatment currently lack access."
The bill would also task the Centers for Medicare and Medicaid Services with developing a payment framework for PDTs and to create new codes reflecting adequate reimbursement.
"Prescription Digital Therapeutics are an excellent example of how innovative technology can address some of the health challenges providers and patients continue to face," said Capito.
THE LARGER TREND
Last year, Dr. Dennis Truong, regional telemedicine/mobility director at Kaiser Permanente, said digital therapeutics can bridge the gap of patient access to care.
"Digital therapeutics can touch and actually complement every part of our delivery system," said Truong. "It helps you right-fit the right care at the right time at the right place. And the patients they do come in, they have more access to the available resources. That also opens up access for the rest of the system too, because the other sick patients that are waiting in the waiting rooms, they actually have a quicker wait time because of improvements in access."
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.