The American Healthcare Quality Board publishes national coverage indications; a service inside an indication is paid on the clinician's attestation. Congress sets the ethical frame and the numbers encoding it, and AHQB applies them — an unelected board choosing a value threshold would be illegitimate, while the same board applying one set by statute is not. The cost-effectiveness corridor governs end-stage life-prolonging therapy only; the rest of the floor is a clinical determination on evidence of benefit, with price disciplined by procurement and negotiation.
Anchor
American Healthcare Quality Board
Publishes national coverage indications; a service inside an indication is paid on clinician attestation. Read component →
Anchor
The coverage standard
A cost-effectiveness corridor that applies to end-stage life-prolonging therapy only — not to the rest of medicine. Read component →
Primary
Reproductive and fertility care
National coverage that does not vary by state residence, plus a two-retrieval fertility benefit with single-embryo transfer as the floor standard. Read component →
Primary
Drug and device pricing
Reference pricing against peer democracies, national purchasing, and managed entry when budget impact is large. Read component →