Inside Drug Pricing - 08/12/2019

Medicare CAR-T Policy Retains Incentive For Hospitals To Game System

By John Wilkerson
August 6, 2019 at 3:30 PM
CMS will increase the add-on payments hospitals receive for CAR-T cancer treatments, but the agency didn’t make what industry sources say are easy changes to the reimbursement system that would have allowed CMS to know the true price of chimeric antigen receptor T-cells. The agency also left in place policies that encourage hospitals to inflate costs they report to Medicare in order to curb losses from Medicare rates that are far below the price of CAR-T. Medicare gives an add-on...

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