Medicare Bonus Payments Awarded To Cook’s Stent, Second Sight’s Eye Implant

Article preview from Medtech Insight - August 2013

Cook Medical’s Zilver PTX stent and Second Sight Medical Products’ Argus II retinal prosthesis system will enjoy new-technology add-on payments in 2014 under CMS’ hospital inpatient prospective payment system final rule.

Medicare Bonus Payments Awarded To Cook’s Stent, Second Sight’s Eye Implant

Article preview from Medtech Insight - August 2013

Three products, including two devices, will receive Medicare hospital inpatient new-technology add-on payments for the first time in fiscal year 2014. Two additional devices that had sought the payments will not qualify because they have yet to gain FDA approval. The Centers for Medicare and Medicaid Services (CMS) announced the decisions in its final inpatient prospective payment system rule, issued August 2 and set to take effect October 1.

The successful applicants were Second Sight Medical Products Inc.’s Argus II retinal prosthesis system, Cook Medical Inc.’s Zilver PTX paclitaxel-eluting peripheral artery stent and CSL Behring’s drug, Kcentra, a replacement therapy for patients who are experiencing severe bleeding and have an acquired coagulation factor deficiency due to warfarin treatment.

CMS concluded that the products meet all three necessary criteria for the add-on payments: newness; a high cost of use such that a regular inpatient diagnosis-related group payment would be inadequate; and proof of substantial clinical improvement in patients.

The add-on payment program is designed to support advanced medical technologies as they are first introduced into the market, before enough patient data has been collected for their costs to be factored into a standard inpatient payment category (MS-DRG).

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