Inside Drug Pricing - 06/01/2020

Hospital Pay Hike For CAR-T Might Impact Medicaid, Commercial Market

By John Wilkerson / May 28, 2020 at 3:52 PM
Now that CMS has proposed paying hospitals significantly more to administer chimeric antigen receptor T-cell (CAR-T) treatments for cancer, hospitals are waiting to see whether state Medicaid programs and the commercial market follow suit. Medicare often influences private insurance pay rates and policies, and the next major update to the commercial market’s system for setting hospital pay rates is in October. On May 11, CMS proposed a national unadjusted pay rate for hospitals that administer CAR-T. The proposed MS-DRG (Medicare...


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