National Marrow Donor Program®/Be The Match® Disappointed CMS IPPS Proposed Rule Does Not Address Reimbursement Barriers for Bone Marrow and Cord Blood Transplants
Current Medicare Reimbursement Limits Access to Transplant in Inpatient Settings for Older Americans Diagnosed with Blood Cancers
Apr 18, 2017, 10:38 ET
MINNEAPOLIS, April 18, 2017 /PRNewswire-USNewswire/ -- National Marrow Donor Program® (NMDP)/Be The Match®, which operates the nation's Be The Match Registry® of potential adult volunteer marrow donors and donated umbilical cord blood units, today expressed disappointment that the Centers for Medicare & Medicaid Services (CMS) did not include a payment policy change to Medicare's reimbursement for bone marrow and cord blood transplant in the FY2018 hospital inpatient prospective payment system (IPPS) proposed rule. Current inpatient rates do not cover hospital treatment costs, most notably the acquisition cost for bone marrow and cord blood for transplant. While CMS recently increased Medicare reimbursement for transplant performed in the outpatient setting, it did not make similar policy changes in its IPPS proposed rule.
"We hoped CMS would issue a proposed rule to address underfunding issues for our nation's bone marrow and cord blood transplant centers to support access to life-saving transplant for Medicare beneficiaries," said Jeffrey W. Chell, M.D., Chief Executive Officer of NMDP/Be The Match. "While we commend CMS for increasing reimbursement for transplant performed in the outpatient setting, the IPPS proposed rule still does not address reimbursement issues for bone marrow and cord blood transplants performed in a hospital setting. We are hopeful that we can work with CMS to make this update in its final rule, making sure the final rule brings us closer to paying for cell acquisition costs and adequately covering the cost of transplant for seniors for whom transplant is the only curative path."
In 2016, CMS issued a final rule for transplants performed in the outpatient setting, which included significant changes to reimbursement and the methodology for reporting costs related to bone marrow and cord blood transplants. Ninety seven percent of transplants, however, are performed in the inpatient setting, underscoring the urgent need to address the underpayment to hospitals under the current methodology.
"We will continue to work on behalf of patients to eliminate access barriers to transplant," Chell added. "We look forward to working with CMS to capture the true costs of transplants in the inpatient setting, build a model for reimbursement that separates cell acquisition costs from the MS-DRG rate, and ultimately create an FY2018 final rule that aligns more with how CMS reimburses the acquisition costs of solid organs."
About National Marrow Donor Program® (NMDP)/Be The Match®
National Marrow Donor Program (NMDP)/Be The Match is the global leader in providing a cure to patients with life-threatening blood and marrow cancers such as leukemia and lymphoma, as well as other diseases. The nonprofit organization manages the world's largest registry of potential marrow donors and cord blood units, connects patients to their donor match for a life-saving marrow or umbilical cord blood transplant, educates health care professionals and conducts research through its research program, CIBMTR® (Center for International Blood and Marrow Transplant Research®), so more lives can be saved. NMDP/Be The Match also provides patient support and enlists the community to join the Be The Match Registry®, contribute financially and volunteer.
To learn more about the cure, visit BeTheMatch.org or call 1 (800) MARROW-2.
SOURCE National Marrow Donor Program