HTA is not performed systematically nor is systematically tied to insurance coverage determinations, except for coverage of clinical preventive services. Insurers may use the work of groups such as ICER to inform their coverage decisions but this will vary by payer. The Medicare program uses an evidence-based process, which allow for public input to make national coverage decisions and is exploring a new voluntary pathway for coverage of certain breakthrough FDA-approved devices. See: https://www.cms.gov/blog/transforming-medicare-coverage-new-medicare-coverage-pathway-emerging-technologies-and-revamped