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REIMBURSEMENT UPDATE

Medicare Reimbursement Update

Our Payer Policy team has had several conversations with the Centers for Medicare & Medicaid Services (CMS) over the past few months around inpatient reimbursement in advance of the FY 2018 Inpatient Prospective Payment System (IPPS) Proposed Rule.

As you may recall, the FY 2017 IPPS base reimbursement rate is $69,844 for MS-DRG 014 Allogeneic hematopoietic cell transplant (HCT). That amount is intended to be inclusive of the inpatient stay as well as all donor search and cell acquisition costs and is not adequate to cover these costs. We continue to work on regulatory and legislative solutions that would appropriately reimburse the cost of donor search and cell acquisition. Please look for more information on how you can get involved and advocate for increased reimbursement in the coming months.

If you have specific questions about Medicare Reimbursement or would like to be involved in our FY18 IPPS efforts, please contact Alicia Silver at alicia.silver@nmdp.org or 763-406-8669.

Donor Collection Coding & Billing Guide

A new Donor Collection Coding & Billing Guide is now available online. The guide breaks down the three phases of donor collection: donor search, donor work-up and collection. Each phase gives a breakdown of what services will occur during this time and what codes can be billed.

Advisory Group on Financial Barriers to Transplant

The NMDP/Be The Match’s Advisory Group on Financial Barriers to Transplant (AGFBT) would like to introduce our new Chair, Ruth Brentari, Executive Director, National Transplant Services at Kaiser Permanente and Vice-Chair, Dr. Nandita Kehra of the Mayo Clinic. The AGFBT is made up of payers, reinsurers, transplant networks, and transplant center administrators and medical directors. The AGFBT continues to work on collaborative initiatives that reduce financial to transplant and increase access and awareness of this life-saving treatment.

Medicare Cost Report Webinar

Join us on March 21 from 11:00 a.m. - 12:00 p.m. CST for a webinar focused on HCT and its place in the Medicare Cost Report (MCR). Medicare experts Jugna Shah and Valerie Rinkle of Nimitt Consulting will provide an overview of the basic elements of the MCR and take a deeper dive into HCT sections. Participants will gain a greater understanding of how the MCR is structured and where to report HCT related costs.

Register now: Network.BeTheMatchClinical.org/MarchWebinar

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If you have any questions or need additional information, please contact the Payer Policy Team at PayerPolicy@nmdp.org. All of our resources are available on our website: Network.BeTheMatchClinical.org/Reimbursement.

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