Medicare Boosts Payment Rates For Pricey New Treatments, But Health Providers Disappointed It’s Not More
“Under this plan, I have concern that access to CAR T won’t be universal,” said Jayson Slotnik, a partner at Health Policy Strategies. Some argue Medicare should pay for 80 to 100 percent of the pricey cancer treatment. In other Medicare news, CMS finalizes a long-requested wage index boost.
The Washington Post:
Medicare Boosts Payment Rates For CAR T-Cell Therapy, A Pioneering Cancer Drug
Medicare officials on Friday said it would increase reimbursements to hospitals for expensive new medical technologies, including a high-priced therapy used as a last-resort treatment for patients with blood cancers. The Centers for Medicare and Medicaid Services issued a final rule raising payments for new technologies from 50 percent to 65 percent of estimated costs. CMS Administrator Seema Verma said the step would promote access to potentially lifesaving treatments and reduce uncertainty about payments for a cancer immunotherapy known as CAR T-cell therapy, among other new therapies. (McGinley, 8/2)
CQ:
Medicare Boosts Payments For Rural Hospitals, New Technologies
The Centers for Medicare and Medicaid Services finalized a rule Friday that will boost payments for rural hospitals and innovative treatments under Medicare in 2020. The final rule is expected to increase hospitals’ pay by $3.8 billion, or 3 percent, next year. CMS originally proposed a $4.7 billion, or 3.7 percent, increase. (Clason, 8/2)
Modern Healthcare:
Medicare Finalizes Rural Wage Index Boost
Starting Oct. 1, rural hospitals across the U.S. will get the wage index boost they have long begged for, the CMS' said in its final rule on inpatient prospective hospital payments for fiscal 2020. The agency's original proposal would have made this change by redistributing money from the top 25% of hospitals—such as politically heavyweight states like California and New York. In the final rule, the CMS will instead decrease payments across the board and cap any cut at 5%. (Luthi, 8/2)
And in other news out of CMS —
Modern Healthcare:
CMS Delays Funding Renewal For Quality Improvement Organizations
The 13 quality improvement organizations that are part of CMS' Quality Innovation Network are halting operations and laying off staff as they wait for the agency to renew their multimillion-dollar contract. The $960 million contract, which ended in mid-July, wasn't renewed and won't be until sometime between September and November, according to a CMS memo to the organizations last month. The CMS didn't offer a reason in the memo for the delay in funding, but an agency spokeswoman said in an email to Modern Healthcare that some of the work performed by the quality improvement organizations for the expired five-year contract isn't ending until Oct. 16. (Castellucci, 8/2)
