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Washington State Clinicians Committee Recommends Covering Glucose Monitoring, Limit Spinal Injections
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For Immediate Release: 03/22/2011
Contact: Doug Porter, Administrator, Health Care Authority/State Medicaid Director, 360-725-1040; Richard Onizuka, Director of Health Policy, HCA/Medicaid 360-923-2820; Leah Hole-Curry, Director, Health Technology Assessment Program, 360-923-2748

SEA-TAC, Wash. – A Health Technology Clinical Committee that has increased use of medical tests and treatment proven to work and saved taxpayers more than $31 million last year on tests and treatments that don't work will take final public comments over the next two months on two draft findings.

At its meeting here on Friday, March 18, the committee found that:

  • Evidence supports the use of self monitoring of blood glucose (test strips) in insulin dependent children, and it remains fully covered. There isn’t good evidence to establish optimal frequency, so no quantity limits were set. Evidence is weak for use of continuous glucose monitoring devices, and they will be covered only for individuals in a trial setting or with severe hypoglycemia.
  • Evidence overall is low to support the use of injections of pain medicine around the nerves in the spine – with many trials showing no better outcomes than the placebo or saline injection. Epidural spine and sacroiliac joint injections had slightly stronger evidence of short term pain relief, and coverage under certain conditions was approved, while others were not approved based on the very low evidence or conflicting evidence showing no benefit.

The committee's decisions will be published on the internet (www.hta.hca.wa.gov) by the Health Technology Assessment program for public comment beginning next week. The decisions will not be finalized until the next quarterly meeting in May 2011. 

The Health Technology Assessment committee is an independent panel of 11 practicing health care professionals who make coverage decisions for state-funded programs.  Using independent clinical evidence, the HTCC determines if certain procedures or technologies are safe, effective, and cost-effective.

The committee’s decisions are used to determine whether the procedures will be covered under public-funded health coverage in Medicaid, state employee health benefits, worker compensation or other state-purchased health care.

Health Technology Assessment Program Director Leah Hole-Curry said the program was created by the Legislature to make decisions about paying for medical care that is proven safe, effective, and has value. As much as one-third of the nation’s total health care spending currently goes toward treatments that do not work.

"We need to spend state resources wisely on quality care found by using independent reports and unbiased, local clinicians in a public process," she said.

Since 2007, the program's committee has finalized 21 coverage decisions:

  • The committee recommended against coverage of 10 of the technologies after finding that evidence showed the technology did not work or that evidence does not yet show net health benefits.
  • Eleven other technologies were recommended for coverage under certain conditions where evidence demonstrated benefit.

Overall, the committee's work is saving the state more than $31 million annually in cost avoidance for unproven, ineffective, or unsafe medical care since its creation by the Legislature in 2007.

FOR ADDITIONAL BACKGROUND: