Medicaid Payments For Cell, Gene Therapies Outside Hospital Bundle Supported By Developers

 
• By Cathy Kelly
  
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Separate, and higher, payments outside the bundle means manufacturers will owe Medicaid rebates, and that is OK, Alliance for Regenerative Medicine tells Sen. Cassidy. But manufacturers want assurances they won't be liable for rebates on treatments included in bundled payments.

Bundled Payments More Typical For Cell and Gene Therapies In Medicaid • Source: Shutterstock

Congress should encourage the Centers for Medicare and Medicaid Services to clarify that Medicaid programs have the authority to reimburse hospitals for cell and gene therapy outside the typical payment bundle, the Alliance for Regenerative Medicine recommended in comments to Senate Health, Education Labor and Pensions ranking Republican Bill Cassidy, LA.

Key Takeaways

  • Separate Medicaid payments to hospitals for cell and gene therapy could increase payment amounts and uptake by providers, ARM said. 

The comments respond to a request for information issued by Cassidy in early December. The RFI invited stakeholder input...

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