Coverage and Optimal Reporting of HCT for 2018 - A Webinar Opportunity
and implementing accurate and complete claims and cost reporting can
fundamentally transform the existing inpatient MS-DRG 014 reimbursement for
allogeneic HCT, yet not all transplant centers’ reporting practices are up to
par. Our experts will review correct coding of allogeneic stem cell
transplants and current reimbursement rates along with claim billing rules and
unrelated donor expense. Provider financial practices will be analyzed with
regard to their impact on Medicare and commercial payer reimbursement.
will specifically review what transplant centers need to “self-audit” in terms
of correctly prepared claims, including the reporting of all charges,
professional services, and submission of cost reporting information for donor
search and cell acquisition. Our experts will also cover the importance
of appropriate mark-up practices and the regulatory requirements while taking
pre-billing contractual allowances/discount deductions to meet commercial
We will also present a brief update on our strategy to increase
transplant coverage for Medicare beneficiaries who are diagnosed with lymphoma.
There will be time for a Q&A session with our experts at the end.
Join us on Thursday, April 19 from 12:00 to 1:30 p.m. CDT for this important webinar and be sure to invite your coding, billing,
revenue cycle, charge description, payer contracting and cost reporting staff.
Register for this webinar
Your Center-Specific 2018 Medicare Reimbursement Report
If you weren’t
able to pick up your center’s report during the 2018 BMT Tandem Meetings Administrative Directors Conference, you are still able to request the report
from the NMDP Public and Payer Policy department. Your center-specific report
includes up-to-date Medicare data on how frequently your center bills revenue
code 0815 for allogeneic HCT. Our team is also available for questions or further consult by
information or to request your center’s report, please email PayerPolicy@NMDP.org.
We Still Need Your Support for Reforming Medicare Reimbursement ─ PACT Act (HR 4215)!
The Centers for Medicare and Medicaid Services (CMS) has not addressed inadequate Medicare
reimbursement for allogeneic HCT and search and acquisition costs. Within the
next month, the 2019 Inpatient Prospective Payment System (IPPS) rule proposal
will be published for comment and we need to be ready to demonstrate support of
HR 4215 in large numbers. Your dedication to protecting patient access to
transplant and support of HR 4215 is absolutely necessary. If
you haven’t done so already, please contact your legislators today!
New HCT and Fertility Module
The Patient and
Health Professional Services department at NMDP/Be The Match is excited to
present a new resource on HCT and fertility education! Fertility is a concern
for many patients who require medically necessary, life-saving treatments
that are potentially harmful to reproductive health. Being transparent with
patients about their fertility is important, but it is understandably difficult
when there are immediate concerns about treating a life-threatening disease.
This fertility education moduleis designed to help providers
facilitate a conversation with patients and to help the patient self-advocate,
ask the right questions, and navigate insurance coverage for fertility
2018 BMT Tandem Meetings Recap
Now that the
frenzy of Tandem is over, many of us will take time to reflect on the year gone
by and refocus our energy on new strategies. Public and Payer Policy team
members facilitated an Advisory Group on Barriers to Transplant (AGBT)
discussion around defining CAR-T value, financial toxicity, and value-based
insurance with the hopes of identifying areas still needing more work. During
the Administrative Directors Conference, Susan Leppke, the Director of Public
and Payer Policy, presented valuable information on changes to Medicare
coverage, reimbursement and coding with fellow experts Stephanie Farnia from
ASBMT and Jugna Shah from Nimitt Consulting.
Some of the quiz-bowl questions at
the end of the presentation were easy for most audience members to answer (do
not bill donors for donor search and cell acquisition), while others were not
as straightforward (hospital cost report line 77 is effective 1/1/2017 for
reporting all allogeneic HCT donor search and cell acquisition costs).
Our team also
valued the discussions around survivorship, fertility education, research
efforts to decrease CAR-T toxicity, and defining effectiveness and value in the
ever-changing cellular therapy and transplant space.
And while the
meeting ended with a fun night of dancing and socializing, we are always
thinking about the challenges ahead that connect us through a single mission
– saving lives through transplant and cellular therapy. The Public and Payer
Policy team thanks everyone for a great meeting. See you next year!
Where can you find us
next? You can find Public and Payer Policy
team members exhibiting at the 23rd NCCN
Annual Conference: Improving the Quality, Effectiveness, and Efficiency of
Cancer Care, March 22 – 24, 2018, in Orlando,
Florida. Please stop by and say hello! We would love to talk to you.
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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.