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December 27, 2006

Medicare Requirement for Research Participation

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2006;296(24):2923-2925. doi:10.1001/jama.296.24.2923-b

To the Editor: In their Commentary, Dr Pearson and colleagues1 discuss the ethics of the relatively new policy by the Centers for Medicare & Medicaid Services (CMS) for coverage with evidence development (CED). This has been required for expanded coverage of such technologies as implantable cardioverter-defibrillators2 and carotid stent systems.3 I am concerned about the authors' assertion that differential access to CED technologies by various segments of the Medicare population is “a regrettable practical reality but does not constitute an injustice.”