Care Coordination Working Group Publishes New Framework in Blood Advances
Our Advisory Group on Financial Barriers to Transplant’s Care Coordination Working Group led by Patricia Martin and Nandita Khera recently published a patient care coordination framework in Blood Advances designed to inform referring physicians and payers on the six key components of the hematopoietic cell transplant (HCT) continuum of care. The framework focuses on coverage policy and benefit design as well as influence timely referral to HCT. The Care Coordination Working Group is in the process of developing a related toolkit, which can be used to identify and address care coordination issues for HCT patients.
Read the article: Khera N., et al. Blood Advances
Jason Carter Clinical Trials Program
A clinical trial may be the only option for some patients who require life-saving HCT, but finding the right one can be challenging for most patients. We are excited to introduce the Jason Carter Clinical Trials Program, a patient-friendly online tool that will help patients and their families navigate complicated clinical trial descriptions and eligibility criteria. The program was graciously funded by the Carter family in memory of their son and brother, Jason Carter. Contact our Clinical Trial Patient Education Specialist to find answers to questions and prepare patients for more informed conversations with you.
Visit JCCTP.org to learn more.
Council Meeting 2017 Session Highlight Health Policy, Advocacy & HCT
Join the Public and Payer Policy team at our Council Meeting in Minneapolis, November 10-11. We are excited to share with you our strategy for expanding Medicare coverage of HCT to include lymphoma, new coding and billing resources, Medicare reimbursement updates, advocacy and grassroots opportunities, and to reflect on the key policy and advocacy successes that could not have been possible without the collaborative effort of health professionals like you.
Join us at Council 2017
CAR T-cell Update
The American Society of Blood and Marrow Transplantation (ASBMT) has been working diligently with the Centers for Medicare & Medicaid Services (CMS), in collaboration with the our Public and Payer Policy team, to establish an appropriate billing mechanism for FDA-approved CAR T-cell therapies. The following new ICD-10-PCS codes, effective 10/1/2017, are unique to CAR T products and can be billed to all payer types and for all CAR T products:
XW033C3: New Technology, Introduction via Peripheral Vein; Engineered Autologous Chimeric Antigen Receptor T-cell Immunotherapy
XW043C3: New Technology, Introduction via Central Vein; Engineered Autologous Chimeric Antigen Receptor T-cell Immunotherapy
Additionally, HCT physicians can now formally self-identify as Hematopoietic Cell Transplant and Cellular Therapy (HCTCT) physicians using CMS-855I and CMS-855O application forms. Further guidance related HCTCT physician designation can be referenced in MLN Matters (MM9957); TC billing staff should be made aware of these changes.
Read more about CAR-T coding and ASBMT’s policy efforts in DC.
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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.