A $1.6B cut in 340B payments
On Nov. 1, Medicare released its final rule regulating outpatient payments for 2018. The most dramatic change is the reduction in reimbursement for separately payable drugs under the 340B program. Effective Jan. 1, reimbursement drops from average sales price (ASP) +6% to ASP -22.5%. CMS estimates that this change will save $1.6 billion in 2018, which will be redistributed across all facilities billing under HOPPS. Read the post
Register for the Dec. 14 webconference: 2018 Oncology Medicare Reimbursement Update
Hospitals not giving up without a fight
Less than two weeks after CMS released its final rule, several organizations filed a lawsuit against HHS: the American Hospital Association (AHA), Association of American Medical Colleges (AAMC), and America's Essential Hospitals (AEH), as well as Eastern Maine Healthcare Systems, Henry Ford Health System, and Park Ridge Health. The organizations claim that the 340B cuts violate the Social Security Act and exceed the HHS secretary's authority because Congress had intended for hospitals to receive discounts under the program. The groups are seeking an injunction to stop HHS from implementing the cuts pending the lawsuit's resolution. Read the post
Excitement—and cost concerns—around CAR T-cell therapies
Recent months have been groundbreaking for the use of immunotherapy in cancer treatment as the FDA approved the first two CAR T-cell therapies. However, despite widespread excitement, experts continue to express concern about the costs. Kymriah, while priced at $475,000, will likely end up costing over $1 million per patient when including the costs of labor and the intense symptom management support patients will need. Read the post
FDA authorizes 468-gene panel created by Memorial Sloan Kettering
MSK-IMPACT is the first laboratory-developed tumor profiling test to receive authorization through FDA. It uses next-generation sequencing to profile 468 unique genes, along with other molecular changes in the genomic makeup of an individual tumor. As these types of tests proliferate across the country, this authorization paves the way for the review and availability of other next-gen-based profiling tools. Read the post
