Medtech companies still in talks with insurers to get their treatments covered

economictimes.indiatimes.com:

medtech companies say they still face some obstacles in getting their technology covered under a few companies’ plans. Insurance consultants, who are helping facilitate the dialogue between medtech and insurance companies, told ET that this may be because of ambiguity in the wording of the directive from Insurance Regulatory and Development Authority of India (IRDAI). “The directive says the treatments will be covered whenever medically indicated, which can be interpreted as ‘only covered if necessary,’ and not by the patients’ choice,” they said.

Insurance companies, medtech firms say, use this to reject technologies like Robotic-assisted surgeries (RAS). The insurance loopholes, companies say, are hampering their growth in the country. Mandeep Singh Kumar, the VP of Intuitive Surgical India, which builds technology for RAS, told ET that many health insurance policies have sub-limits, restraining full access of their product to a wider section of the population.

“One of the best ways to address this gap is to sensitize patients, providers (hospitals), and payers (insurance companies) about the benefits of RAS,” he said. The Nasdaq-listed company, whose Indian operations are headquartered in Bengaluru, is in talks with several insurance firms to get their procedures universally approved. “We are also working with Third Party Administrators (TPA) to ensure that the mandate for comprehensive coverage of RAS is uniformly applied,” said Kumar.