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Policy Category: Reimbursement

PMC advises Medicare and Medicaid officials on reimbursement policies that can help ensure sustainable patient access to personalized medicine. In 2020, for example, PMC began advocating for increased Medicare payment rates for hospitals that provide chimeric antigen receptor T-cell therapies, a potentially life-saving class of personalized cancer treatments. PMC’s recommended payment solution is still in place today.

U.S. House of Representatives Ways and Means Health Subcommittee Hearing on Policies That Inhibit Innovation and Patient Access

Legislation to Ensure Predictable and Sustainable Medicare Payments for Laboratory Services/Saving Access to Laboratory Services Act

Inflation Reduction Act/Medicare Drug Price Negotiation Program

Legislation to Enable Medicare Reimbursement for Genetic Counselors

CMS’ Request for Information About Opportunities to Improve Care for Patients Covered by Medicare Advantage Plans

CMS’ Proposals Related to Quality Measures in the 2023 Physician Fee Schedule

Medicare Payments for Chimeric Antigen Receptor T-Cell Therapies

CMS’ Proposal to Discontinue the Use of ICD-10 NOS Reimbursement Codes

CMS’ Telehealth Policies

CMS’ Clinical Laboratory Fee Schedule

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