Payment Increase
In its final FY 2020 Medicare Hospital Inpatient Prospective Payment System rule released on August 2, the Centers for Medicare and Medicaid Services, increased the marginal rate of technology add-on payments for chimeric antigen receptor (CAR) T-cell therapies from 50% to 65%. CAR T-cell therapy is a form of immunotherapy that uses specially altered T cells, a part of the body’s immune system, to kill tumors and fight cancer. The payment increase would only apply for two years.

The 15% increase has generally received favorably reviews. However, some stakeholders have expressed concern that the increase, while promoting patient access, will not cover the full costs associated with providing the treatment.

The FDA has approved two CAR T-cell therapies to treat people with certain cancers — adults with relapsed or refractory large B-cell lymphoma, and children with relapsed or refractory acute lymphoblastic leukemia.

The new payment rules take effect October 1.

Additional Read: 
Medicare Boosts Payment for Breakthrough Cancer Therapy - The Washington Post