Some Medtech Wins, Many Wait-and-Sees in Medicare Inpatient Proposal

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ARTICLE SUMMARY:

The recently issued FY 2021 CMS inpatient proposal is the first to implement a new fast-track path to new-tech bonus payments for Breakthrough Devices, and two heart failure technologies, including the BAROSTIM NEO made the grade. The reimbursement prospects for an array of other devices remain unclear. A quick look at the recent Medicare NTAP proposals.

It came in at over 1,500 pages, but the Centers for Medicare and Medicaid Services made clear that this year’s hospital Inpatient Prospective Payment System proposal (for fiscal year 2021) was restrained by the ongoing pandemic. “CMS has limited annual rulemaking required by statute to focus primarily on essential policies including Medicare payment to hospitals, as well as proposals that reduce provider burden and may help providers in the COVID-19 response,” the agency stated in its May 11 release of the proposed rule.

That said, it was a noteworthy rule to check on for medtech updates, as the FY 2021 rule is the first that applies a new fast-tracking policy for FDA-designated Breakthrough Devices to qualify for inpatient New Technology Add-On Payments (NTAP). Even amid the public health crisis, at least two technologies, both targeting heart failure, are poised to take advantage of the new quick route to bonus payments.

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