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The proposal is known as Tier VI because it would be added to five existing pension benefit categories.
To avoid a non-inclusion of categories due to the low number of observations, we included all benefit categories and indication classes too.
The small number of observations (especially when differing by benefit categories, drug status or indication) and the wide spread of negotiated discounts limit our analysis.
The larger estimates still being reported from some studies reflect speculative extensions of standard models, and/or very simple, separate estimates of additional benefit categories, not the core results of established modeling methodologies.
It is my understanding that the Secretary of HHS is required to develop, through regulation, standard definitions of many terms for purposes of comparing benefit categories from one private health plan to another and it is my expectation prosthetics, orthotics and related supplies will be defined separately from 'durable medical equipment'".
Thus, rather than rating a series of pre-established benefit categories, the interviews drew out perceived benefits through open-ended discussions.
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"I should definitely put this in the benefit category".
Plans could modify coverage within a benefit category so long as they did not reduce the value of coverage.
Table 4 presents the results per indication class and benefit category.
No significant differences were shown for discounts per benefit category, indication class or drug status (orphan/non-orphan) (Table 6).
The data collection and reporting rules3, 10, 11 require insurers to use standard medical procedure and diagnosis codes when developing claim information for each benefit category.
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CEO of Professional Science Editing for Scientists @ prosciediting.com