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New Medicare Rule Opens Up Gene Therapy Access For Recipients

Medicare will increase hospital payments for 2019 in hopes of improving patient access to price and health information and new cancer treatments.
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New Medicare Rule Opens Up Gene Therapy Access For Recipients

The Centers for Medicare and Medicaid Services published its new rule for fiscal year 2019, increasing hospital payments and broadening access to new treatments for cancer patients. 

CMS will now pay hospitals around $4.8 billion more for inpatient services. That's up from the $4 billion increase that was proposed earlier this year. And it's a substantial raise from the $2.4 billion CMS paid hospitals for fiscal year 2018

According to CMS Administrator Seema Verma, the new rule will improve patients’ access to hospital price and health information, and “allow clinicians to spend more time with their patients.” 

One of the new policies promotes payment transparency, requiring hospitals to publish inpatient list prices online. 

CMS has also decided to approve add-on payments for a new cancer treatment known as CAR T. It's a gene therapy that attacks cancer by using the patient's own immune system, and it's expensive. Both FDA-approved treatments have a six-figure list price. Medical lobbyists say the extra reimbursements from CMS will help more patients take advantage of it. 

And because the agency expects more uninsured people in the U.S., CMS upped supplemental payments by $1.5 billion to hospitals that treat people who are most in need financially.