CMS Proposed 2008 HOPPS Payments Include Modest Increases for Blood Products, Notable Improvements for Some Cellular Therapy Procedures
Under a proposed rule for 2008 Medicare payments for hospital outpatient services, the Centers for Medicare and Medicaid Services, has proposed modest payment increases for most frequently transfused blood products. However, reimbursement for many blood products and services would continue to lag behind actual costs. CMS proposed more dramatic increases for some bone marrow and stem cell related procedures and for the first time has agreed to recognize certain CPT codes for bone marrow/stem cell processing. AABB has prepared a summary of the proposed rule's treatment of blood products and transfusion and cellular therapy procedures.

AABB Responds to CMS Proposal on Clinical Trial Coverage
In an effort to improve reimbursement to patients involved in clinical trials, AABB has submitted a response to the Centers for Medicare and Medicaid Services (CMS) concerning its proposed revisions to the Medicare National Clinical Research Policy. In a May 9 letter, AABB stressed the important role clinical research plays in advancing quality care for patients requiring transfusions as well as those battling certain cancers and other life-threatening conditions treated with hematopoietic stem cell transplants. AABB requested that CMS amend its proposed policy to ensure that Medicare beneficiaries have access to approved clinical trials. The association also requested that CMS not abandon its current policy allowing for coverage of investigational new drug (IND)-exempt studies, such as those involving the off-label use of drugs or biologics — including cellular therapy products that are likely to be approved but used off-label in trials during the coming years. Additionally, AABB urged CMS to cover trials under investigational device exemption (IDE), noting that in some instances FDA considers cellular product processing procedures and the resultant product a biologic subject to IND review and in other instances considers them a device subject to IDE review.

CMS Releases Final 2007 Outpatient Rule and Blood Payments
The Centers for Medicare and Medicaid Services (CMS) recently announced its final 2007 payment rates for blood and transfusion, bone marrow and hematopoietic stem cell related services provided in the outpatient setting.  For a complete list of these rates, which take effect Jan. 1, 2007, and additional background information, click here. 

AABB Urges CMS to Increase 2007 Outpatient Payments for Blood Products
Commenting on Medicare’s 2007 Hospital Outpatient Prospective Payment System proposed rule, AABB urged the Centers for Medicare and Medicaid Services (CMS) to increase its proposed payment of only $177 for leukocyte-reduced red blood cells, the most frequently transfused component. As a related matter, AABB has produced a summary of Medicare's recently proposed 2007 payments for outpatient blood products and transfusion medicine and cellular therapy services. 
Click here to view the comments. (PDF)

AABB Asks Medicare to Improve Payments for Cell Therapy Procedures
AABB recently wrote to the Centers for Medicare and Medicaid Services (CMS) expressing concerns about Medicare payments for bone marrow and peripheral blood progenitor cell processing services.  AABB stated in the letter that it strongly believes that CMS payments for such services need to be adjusted to reflect the actual costs of providing potentially life-saving care.  The specific CPT codes referenced in the letter include 38207-38215 and 38204. 

Click here to view the letter. (PDF)