HealthLeaders Media August 13, 2019
The inpatient prospective payment system provides for a new technology add-on payment, but it is vital for hospitals to understand the formula CMS uses to calculate it.
The inpatient prospective payment system (IPPS) that CMS and many state Medicaid payers as well as commercial payers rely upon is not capable of appropriately paying for the high costs of new technology, particularly breakthrough drugs.
As of 2001, the IPPS provides for a new technology add-on payment (NTAP) that pays an amount above and beyond the DRG payment for qualifying new technologies that meet CMS criteria.
Yet most hospitals do not understand that this is a formula that pays the lesser of a calculated amount up to the cap that CMS establishes—which,...
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