Lexology August 27, 2024
On August 1, 2024, the U.S. Centers for Medicare and Medicaid Services (CMS) issued the Fiscal Year 2025 Hospital Inpatient Prospective Payment Systems final rule (Final Rule), which updates Medicare fee-for-service payment rates and policies for in-patient hospitals and long-term-care hospitals.
Notably, the Final Rule includes key updates to new technology add-on payments (NTAPs) for approved cell and gene therapies (CGT) indicated for the treatment of sickle cell disease, both of which were approved in late 2023. Specifically, despite historic reluctance to increase NTAP payments, following receipt of public feedback regarding the adequacy of NTAP payments for CGT to treat sickle cell disease, CMS announced an increase to the NTAP percentage from 65% to 75% for approved sickle cell disease...
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