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FEATURE STORIES

Bipartisan Bill HR 4215 Introduced to Protect Patient Access to HCT

Earlier this month, U.S. Representatives Erik Paulsen (MN-03), Doris Matsui (CA-06), Gus Bilirakis (FL-12), and Ron Kind (WI-03) introduced the Protect Access to Cellular Transplant (PACT) Act (HR 4215). If passed into law, this bill would require Medicare to reimburse hospitals for hematopoietic cell transplantation (HCT) donor search and cell acquisition costs on a reasonable cost basis and separately from the MS-DRG 014 reimbursement, which is approximately $65,000.

Separating reimbursement for donor search and cell acquisition costs from the inpatient stay mirrors Medicare payment policy for organ procurement in solid organ transplantation and would allow hospitals to more adequately recoup the costs of providing life-saving HCT for their patients. If you haven’t yet, please ask your Members of Congress to cosponsor this important piece of legislation and protect patient access to HCT.

CAR-T Coding Update

The American Society for Blood and Marrow Transplantation (ASBMT) has been working diligently with the Centers for Medicare & Medicaid Services (CMS), in collaboration with our Public and Payer Policy team, to establish an appropriate billing mechanism for FDA-approved CAR-T therapies. The following new CAR-T ICD-10-PCS codes, effective 10/1/2017, can be billed to all payers 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). Transplant center billing staff should be made aware of these changes.

Read more about CAR-T coding.

Meet Thor

Thor has been waiting for his marrow match for more than two years. Diagnosed with sickle cell disease at just three weeks old, Thor receives regular blood transfusions as temporary treatment but he is in excruciating pain and the only cure is a marrow transplant. The search is exhausting but we are more committed than ever to finding his life-saving marrow donor.

Learn more about sickle cell disease and find resources to share with your members.

HCT RESEARCH

New Patient Care Coordination Model Addresses Complexities of HCT Therapy

The Advisory Group on Financial Barriers to Transplant (AGFBT), a multi-disciplinary team facilitated by the National Marrow Donor Program® (NMDP)/Be The Match® has proposed a care coordination framework to deliver a continuum of care to HCT patients.

Read article.

PATIENT RESOURCES

Jason Carter Clinical Trials Program

The Jason Carter Clinical Trials Program, launched earlier this summer, makes finding clinical trials easier for patients and their families. The online tool provides patient-friendly, easy-to-read descriptions of blood cancer and blood disorder trials from clinicaltrials.gov.

This free program is funded by the Carter family, in memory of their son and brother, Jason Carter who passed away in May 2016 at age 28 from leukemia. The program also provides:

• One-on-one support from a clinical trials specialist for patients and families, answering questions and helping them search for and join trials

• Educational resources for patients and families to help them learn about clinical trials 

If you are interested in this program, visit www.jcctp.org, call 1-888-814-8610, or e-mail clinicaltrials@jcctp.org.

Education Opportunities

On-Demand Education: Setting a Patient-Centered Outcomes Research Agenda in HCT: Priorities in Education, Care Delivery; and Financial Burden
Historically, the HCT community has focused on research to improve the potential for survival. Over the past several years more attention has been given to identifying and conducting research in other significant outcomes of HCT, particularly those that matter most to patients and their caregivers. This on-demand CE activity focuses on education, care delivery and financial burden.

Access education.

Upcoming Conferences 
Be sure to stop by our booth at either conference to connect with our team. Learn about our advocacy efforts as well as new resources and services that could benefit you and your team.

ASH Annual Meeting – Dec. 9-12, 2017, Atlanta, Ga.

BMT Tandem Meetings – Feb. 21-25, 2018, Salt Lake City, Utah

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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: Payer.BeTheMatchClinical.org

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