Policy Perspectives, June 2017
By Stephanie Farnia, ASBMT Director of Health Policy and Strategic Relations
May was an extremely busy month here in the health care policy camp and, as such, I am going to try to fit several updates within the June column. Some of these issues will receive a more substantial write-up in future months – in the meantime, please contact me if you need more information on any particular item.
IPPS Comment Period Ending Soon: As you have noticed from the repeated pushes from ASBMT and the NMDP/Be The Match to get physicians and other transplant leaders to send in comment letters, there are significant issues associated with the CMS FY18 Inpatient Prospective Payment System Proposed Rule. The comment period ends on June 13. Please take a moment to make sure that key stakeholders within your center have submitted a comment directly or through the NMDP portal. Click here to take action. To learn more regarding this rule and the potential impact on our field, listen to this webinar put on by the NMDP and ASBMT.
Payers Misinterpreting CMS Commentary of HCT Site of Care: In April, we had several centers in the Southeastern part of the country contact the ASBMT in regards to a national payer that had modified a transplant policy for their Medicare beneficiaries inappropriately. The policy was changed to require that allogeneic transplantation be performed in the outpatient setting, unless authorized in advance through a special appeal process. The ASBMT worked with the transplant programs affected to author a modified version of this letter addressing the inaccuracies of the CMS document and the payer’s policy modifications. The letter may be utilized by any ASBMT members or their transplant programs if a similar issue is raised in other parts of the country. Please notify the ASBMT office if this is the case, as we would like to track problems and report them to our national Medicare contacts.
HRSA Revises Process for SCTOD Contract: The U.S. Health Services and Resources Administration has modified its previously held plan to re-issue the Stem Cell Therapeutic Outcomes Database (SCTOD) contract through a “sole source” process and is now planning to proceed with a “open and competitive bid” process. This will mean that the CIBMTR, holder of the contract since its inception in 2004, will need to spend significant time and resources to seek to retain the contract. The ASBMT recently sent a letter to HRSA which urges the Agency to proceed with the sole source vendor process as it originally intended. A copy of the letter can be viewed on the ASBMT website.
CMS Issues Initial Guidance for HCT Specialty Designation: In November 2016, CMS recognized Hematopoietic Cell Transplantation and Cellular Therapy as an official sub-specialty designation for purposes of Medicare billing. The initial information on how to modify your classification within your billing system can be found in the MLN Matters Article MM9957. Look for more detailed information on the benefits of this change during the July or August policy column, when we will have the specific process instructions for you to follow.
As always, please reach out with questions or concerns to Stephanie Farnia, Director of Health Policy and Strategic Relations, StephanieFarnia@asbmt.org or (847) 725-2316.
Read the entire June 2017 ASBMT eNews here.