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REIMBURSEMENT UPDATE

Health Care Reform: First Look at the Impact of the AHCA on HCT

As many of you have heard, health care reform efforts are at the center of this Administration’s and the Congress’s policy agenda. Our Payer Policy team has spent time reviewing the proposed legislation, the “American Health Care Act” (AHCA), that if passed would replace the Affordable Care Act (ACA) of 2010. We know that the ACA’s underpinnings helped HCT patients by expanding access to care and ensuring a basic set of quality benefits that support treatment.

The AHCA will likely undergo some revision in committees of jurisdiction before it comes to a floor vote in both the House and the Senate. The legislation as proposed would greatly change the structure of the Medicaid program and the way that lower-income individuals have access to buy private health insurance coverage. It is important to note that the proposed legislation keeps many of the ACA’s most popular patient protections in place, such as children staying on their parent’s health insurance until age 26 and the provision that bars insurers from denying coverage based on preexisting conditions.

We will continue to monitor health care reform developments and assess the impact to our patients, providers and hospitals. Please watch for additional information over the coming weeks about a joint webinar with the ASBMT to explore the impact of health care reform on HCT.

Request for Medicare Anecdotes

Our team continues to work with the Congress and the Centers for Medicare & Medicaid Services (CMS) to increase reimbursement for allogeneic HCT to ensure patient access to care. If your hospital has seen patient access impacted by inadequate Medicare facility reimbursement, we would like to hear from you. Our advocacy efforts will have greater resonance with actual patient stories. Please contact Alicia Silver at alicia.silver@nmdp.org.

NMDP/ASBMT Submit PPACA; Market Stabilization Comment Letter

CMS recently issued a proposed rule, “Patient Protection and Affordable Care Act; Market Stabilization” which aimed to stabilize the current federal market structure for health insurance exchange plans. The proposed rule would eliminate federal network adequacy standards in favor of allowing each state to set their own network adequacy standards. The NMDP/Be The Match and the ASBMT submitted a joint comment letter urging CMS to protect our vulnerable patients by including a HCT center in every network. We believe that this protection would ensure that patients who need a life-saving transplant will not face delays in care.

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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