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Boosts to Medicare Payments for Breakthrough Cancer Treatments

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    The administrator for the Centers for Medicare and Medicaid Services(CMS) said that the agency is proposing a way of boosting reimbursements for a customized approach called CAR T-Cell Therapy. According to an article I found on the subject, it has revolutionized treatment for patients with hard-to-treat pediatric leukemia and adult lymphoma. This particular cancer therapy is very costly, to say the least. Reimbursements in this area would definitely revolutionize how patients with blood cancers such as these handle their medical bills.

    The administrator for CMS said:

    The proposed changes are necessary because “Medicare’s antiquated payment systems” have not kept up with the development of “transformative technologies.” She said she is concerned inadequate payments might be prompting hospitals to limit Medicare patients’ access to needed therapies.

    Also:

    "The agency will boost the size of extra payments it makes to help hospitals incorporate new technologies and treatments into their clinics. Medicare now pays 50 percent of the additional costs of these innovative treatments, but is proposing to increase that to 65 percent."

    The only drawback I find is that the extra payments are only available for the first few years a new product is out on the market. I'm hoping this is a supplementary part of the proposal. Or one could only hope that the treatment or drugs get cheaper as they age on the market. I think it's a step in the right direction. Perhaps we can narrow the margin in which patients with certain cancers like these have a hard time finding the treatment they really need. Is this a legit next step to change such an antiquated payment system? Or is it not enough?

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    I wonder how likely this will be. You know so many departments and agencies propose plans, only to seem them fall apart or end up an a perpetual state of negotiations. I guess that's sort of their job, to make proposals and fight for them. At any rate, I that one drawback that you mentioned, is a pretty big one. "The first few years?" I really hope the treatments get cheaper after that, otherwise people could get stuck in expensive treatments.
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    I don't think it would go to the extremes to where it would further hurt those seeking relief from the plan. What would be the point if it would only further financial difficulties?
Categories: Medicare