Monday, May 11, 2020

Very Brief Blog: CMS Releases FY2021 Inpatient Proposed Rule

CMS typically releases the annual fiscal year proposed inpatient rule around April 20-25; this year it appeared on May 11, 2020, after market close.
  • See the CMS fact sheet here.
    • See the more P.R. oriented press release, here.
  • See the "inspection copy" or advance typescript copy here.
    • It clocks in at 1602 pages.
    • The Federal Register version typically appears about a week later.
    • Comments are taken until July 10.
    • The final rule should appear around August 1, 60 days before the October 1 fiscal year
    • Most early trade journal reactions lead with, "Hospitals slam price transparency proposals," such as:
    • At Dive Healthcare, here.  MedCity News here. Becker's, here.  
NTAP Bonanza; N=24

There is a bonanza of New Technology Add-On Payment applications - usually there are 10 to 12.  This year there are 24.   Of the 24 applications, 9 were in special pathways: 3 as inpatient FDA breakthrough devices, and 9 as QDIP or "Qualified Infectious Disease Products."  All 9 are proposed for approval (these are categorized that are fast tracked to simpler review, inclined toward approval).   

CMS has 15 additional applications besides the 9 just cited.

In addition, CMS plans to add another category to its accelerated NTAP approval for antibiotics.  In addition to the FDA QDIP pathway, they will include products under the LPAD (Limited Population Pathway for Antbacterial and Antifungal Drugs).   

The rule proposes to require increased reporting and public release of private payer rates (e.g. price transparency policy). 

Press Release (Opening)

CMS Builds on Commitment to Transform Healthcare Through Competition and Innovation

"Today, the Trump Administration proposed changes for acute care and long term care hospitals that build on the progress made over the last three years and further the agency’s priority to transform the healthcare delivery system through competition and innovation while providing patients with better value and results. 
The proposed rule would update Medicare payment policies for hospitals paid under the Inpatient Prospective Payment System (IPPS) ... for fiscal year 2021."