AHA Statement on FY 2021 Final IPPS Rule
Senior Vice President, Public Policy Analysis and Development
American Hospital Association
September 2, 2020
The AHA remains deeply disappointed that CMS continues to require hospitals and health systems to disclose privately negotiated contract terms with payers. By continuing to focus on negotiated rates rather than expanding access to a patient’s out-of-pocket costs, the Administration fails to meet the goal it set for itself - assisting consumers in becoming more prudent purchasers of health care. We once again urge the agency to focus on what is really important to patients - ready access to their out-of-pocket costs.
Additionally, this policy will require hospitals to divert critically needed resources during this historic pandemic to administrative tasks that will not benefit patients. We do not believe CMS has the authority to compel the disclosure of these terms and our legal challenge remains ongoing.
While we appreciate the agency’s focus in addressing cost issues for life-saving CAR T therapy, we remain concerned that the policy the agency has put forth in this final rule is not adequate to address the extraordinary level of resources necessary to provide CAR T therapy to patients. We continue to urge CMS to consider an alternative method of determining the cost of CAR T therapy, as well as to consider carving out these very costly new technologies from the MS-DRG and paying for them on a pass-through basis.