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Medicare once again leaves hospitals woefully under-reimbursed for the cost of acquiring cells for transplant placing beneficiary access at risk
April 25 2018
National Marrow Donor Program® (NMDP)/Be The Match®, which operates the nation’s Be The Match Registry® of potential adult volunteer marrow donors and donated umbilical cord blood units, today expressed disappointment that the Centers for Medicare & Medicaid Services (CMS) did not include a payment policy change to Medicare’s reimbursement for bone marrow, peripheral blood stem cell and cord blood transplants. The FY2019 Hospital Inpatient Prospective Payment System (IPPS) Proposed Rule once again does not appropriately reimburse donor search and cell acquisition costs for bone marrow and cord blood transplants despite comments from NMDP/Be The Match and approximately 1,000 others across the transplant community expressing the importance of fixing this reimbursement flaw.
Current inpatient reimbursement rates do not adequately cover hospital treatment costs, most notably the donor search and cell acquisition costs for bone marrow and cord blood transplants. This means that hospitals lose money on each bone marrow or cord blood transplant for a Medicare beneficiary.
“While we understand that CMS has concerns about its authority to make this change, not acting places the lives of Americans who need a life-saving transplant at risk,” said C. Randal Mills, Ph.D., CEO, NMDP/Be The Match. “Given the lack of movement by CMS, we strongly urge Congress to pass legislation to fix this problem so that patients fighting a blood cancer or blood disorder don’t have to also fight to get the only curative therapy.”
Representatives Erik Paulsen (R-MN), Ron Kind (D-WI), Doris Matsui (D-CA), and Gus Bilirakis (R-FL) have introduced H.R. 4215, the Protect Access to Cellular Transplants (PACT) Act. This legislation would adjust the reimbursement structure for hospitals that provide marrow and cord blood transplants to Medicare beneficiaries. The policy change addresses critical underfunding that has caused many hospitals to question their ability to provide the only curative treatment for blood cancers and other blood disorders to Medicare beneficiaries.
“Each year that this problem remains unresolved, transplant centers find it increasingly difficult to transplant these patients because Medicare does not fairly reimburse them for the cost of the cells or the required inpatient care,” Mills added. “Providing a lifesaving transplant for a cancer patient who has no other options, however, is invaluable.”
About National Marrow Donor Program® (NMDP)/Be The Match®
National Marrow Donor Program® (NMDP)/Be The Match® is the global leader in providing a cure to patients with life-threatening blood and marrow cancers such as leukemia and lymphoma, as well as other diseases. The nonprofit organization manages the world’s largest registry of potential marrow donors and cord blood units, connects patients to their donor match for a life-saving marrow or umbilical cord blood transplant, educates health care professionals and conducts research through its research program, CIBMTR® (Center for International Blood and Marrow Transplant Research®), so more lives can be saved. NMDP/Be The Match also provides patient support and enlists the community to join the Be The Match Registry®, contribute financially and volunteer.
To learn more about the cure, visit BeTheMatch.org or call 1 (800) MARROW-2.