Wednesday, September 2, 2020

Very Brief Blog: CMS Publishes Final Inpatient Rule for FY2021

CMS publishes the final inpatient rule for FY2021; see the inspection copy (typescript) here and look for the formatted Federal Register copy on September 18 here.

See trade press here.  CMS continues to push for transparency of Medicare Advantage rates and believes they can inform fee for service rates; look for more lawsuits.   

According to trade press, CMS is providing favorable review for in total 24 new technologies under the New Technology Add on Payment (NTAP) system.  13 are new; 10 are continuing.  5 are related to antibiotics/infection.   It seems like just a few years ago there were usually about 6-8 applicants and less than half succeeded.   CMS has made the process easier, for example, by fast-tracking review of any FDA products that come out of the Breakthrough Technology pathway and creating a fast track pathway for QIDPs, Qualfied Infectious Disease Products and by adding as well a slightly different FDA antibiotics category called LPAD.  They also allow conditional approval for NTAP by CMS even if it falls ahead of the date of FDA final approval.  They're clearly trying hard to fulfill the slogan, "We're the government, and we're here to help."

See the CMS press release here.  “President Trump is committed to ensuring that seniors on Medicare have access to the latest life-saving diagnostics and therapies,” said CMS Administrator Seema Verma.

See the CMS fact sheet here.