Sens. Capito and Shaheen Reintroduce Bill to Expand Access to Prescription Digital Therapeutics
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Senators Shelley Moore Capito, R-W.Va, and Jeanne Shaheen, D-N.H., have reintroduced a bill aimed at expanding access to software-based treatments and creating a reimbursement pathway for software that treats medical conditions.
The Access to Prescription Digital Therapeutics Act of 2023, originally introduced about two years ago, seeks to address the lack of Medicare coverage for digital therapeutics technologies under its current benefit categories.
The bill proposes the creation of a new category for prescription digital therapeutics approved by the FDA and cleared for use among Medicare seniors.
Impact of the Bill
Prescription digital therapeutics (PDTs) are developed and tested similarly to traditional prescription drugs. Instead of taking a pill or injection, patients receive cognitive therapy through software. These treatments undergo rigorous testing for safety and efficacy, FDA evaluation, and prescription by healthcare providers.
Senator Shaheen emphasized the importance of removing barriers to care for those who respond positively to this treatment, stating that many individuals in need currently lack access to prescription digital therapeutics for conditions such as substance use disorders and mental health challenges.
The bill also mandates the Centers for Medicare and Medicaid Services to establish a payment framework for PDTs and create new reimbursement codes to ensure appropriate payment for these therapies.
Industry Trends
Last year, Dr. Dennis Truong of Kaiser Permanente highlighted the potential of digital therapeutics to improve patient access to care and enhance the healthcare delivery system. Digital therapeutics have the ability to complement various aspects of healthcare delivery, offering right-fit care at the right time and place, ultimately improving access for patients and reducing wait times.
Jeff Lagasse is the editor of Healthcare Finance News. For inquiries, contact jlagasse@himss.org. Healthcare Finance News is a publication of HIMSS Media.
