Clinical committee meetings and decisions

Overview

The final product of a technology assessment is a coverage decision that determines whether, and under what circumstances, the state health programs will cover (pay for) use of the assessed technology.

The coverage decision is made by an independent committee of health care providers known as the Health Technology Clinical Committee (HTCC). Members are active clinical practitioners selected by the director of the Health Care Authority (HCA) and cannot have ties to either product manufacturers or the participating state agencies.

The committee holds public meetings four times a year to review the evidence on one or two selected topics. Rules and legislation require the committee to review and vote on benefit coverage using a structured process that relies on scientific, or evidence-based, information.

The primary information source in making a coverage determination is the evidence report/health technology assessment, but the HTCC may also consider other information it deems relevant, including:

• Information provided by the HCA director.
• Reports or testimony from an advisory group.
• Submissions or comments from the public.
• Any unique impacts of a health technology on specific populations based on factors such as sex, age, ethnicity, race, or disability.

The HTCC gives the greatest weight to:

• The evidence it determines to be the most valid and reliable.
• The nature and source of the evidence.
• The empirical characteristics of the studies or trials upon which the evidence is based.
• The consistency of the outcome with comparable studies; recency (date of information); relevance (the applicability of the information to the key questions presented or participating agency programs and clients); and bias.

Process

1. HTCC meeting notices and schedules are published on the HTA website and in the Washington State Register.
2. The technologies to be reviewed at upcoming meetings are listed on the HTA website.
3. Agendas and meeting materials for public meetings are published two weeks prior to the meeting.
4. The HTCC members read materials in advance of the meeting and come prepared to discuss and vote on coverage at the meeting after hearing from the HTA staff, agency representative, public presenters, and the TAC researchers.
5. A quorum of HTCC members is required and a majority vote of those present decides the coverage outcomes.

How to be involved

HTCC meetings are open to the public. Individuals wishing to provide input to the HTCC may provide written comment at least a week prior or oral comment at the meeting. A detailed description of the HTCC meeting participant roles and overview of typical meetings can be found in the HTCC meeting guide. Time at the public meeting is limited, though the committee does appreciate focused comments that inform the committee about facts and direct scientific evidence that individuals consider most important to the committee's charge to make a coverage decision based on the most valid and reliable evidence. Especially:

• Evidence not reviewed but available from peer-reviewed publications.
• Interpretations of the evidence cited in the technology review.
• Criticality of outcomes.
• Study design issues.
• The possibility of developing better evidence, including any pending studies.
• Size of the possible health effect from the technology compared to the existing standard of care.
• Assessment of potential or actual benefits, harms, and costs.
• Recommendations based on the committee's decision criteria.