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Mar 04, 2014

Washington State Accepting Comments on Proposed Review of Six Technologies for Coverage

Published

Mar 04, 2014

On Feb. 28, Washington State’s Health Care Authority (HCA), which administers the state’s Health Technology Assessment (HTA) Program, recommended five technologies to undergo initial review and coverage decisions, and recommended one topic for re-review, beginning in 2015.

WA HCA is soliciting public comments on their recommended topics, as well as on any other topics that it considered for re-review but did not recommend.

Below, find the proposed six topics and the rationale behind their selection: The WA HTA program is one of the most influential regional HTA programs in the U.S. Their technology review program has a direct impact on whether Washington state agencies will pay for a technology and under what circumstances. They also influence other decision-making bodies, including the Virginia Technology Assessment Program, Minnesota’s Health Services Advisory Council, and Oregon’s HERC, as well as the Medicare program.

  • Testosterone Testing: High diffusion; concern for limited evidence for benefit and risk levels, variable and inaccurate test results with unclear normal levels, high estimated treatment costs.
  • Bariatric surgery for overweight/obese: CMS National Coverage Decision (NCD) is limited to morbid obesity with indications expanding into overweight categories.
  • Imaging for rhinosinusitis: Concerns include usage expansion in low risk, high prevalence conditions increases radiation exposure, special consideration for children.
  • Appropriate breast imaging for breast cancer screening in special conditions: Concerns include new concerns for efficacy in special populations (e.g., high risk, dense tissue), high state usage.
  • Tympanostomy tubes: Concerns include variation in use of treatment across different populations (e.g., socioeconomic status), potential overuse in some populations, high state usage.
  • Lumbar fusion (recommended for re-review): New literature identified that could change evidence findings/ original determination (previous review conducted in Nov. 2007).

The WA HCA is accepting comments until March 17, after which the recommendations and public comments will be presented to HCA’s Director for final selection.  Once selected, WA HCA will conduct technology assessments on each of the technologies, which typically takes two to six months to complete. An 11-person committee (called the Health Technology Clinical Committee) will review the evidence and make a decision on whether WA state agencies should cover the technology. There will be opportunities for the public to comment on the draft key questions, draft HTA, and draft coverage decision. The entire review process will take between six and 12 months.

To view the WA HCA’s proposed recommendations, click here.

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