Our team works to achieve sufficient coverage for cellular therapies and monitors policies that could impact patient access to those therapies. Learn more about our work advocating for coverage and read our comment letters on key coverage issues.
Medicare Drug Coverage
NMDP submitted a comment letter to the proposed rule, "Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses," detailing our concerns regarding applying utilization management tools, prior authorization and step therapy, to protected class drugs, which include chemotherapy and immunosuppressive drugs, as well as other exclusions. Read the comment letter. (2019)
Medicaid Network Adequacy
NMDP submitted a comment letter to the proposed rule, "Medicaid Program; Medicaid and Children’s Health Insurance Program (CHIP) Managed Care," detailing our concerns regarding access barriers for patients with proposed changes to network adequacy requirements and standards regarding "specialist" definitions. Read the comment letter. (2019)
NMDP signed a letter to CMS regarding improved reimbursement for CAR-T therapy. Read the comment letter. (2019).
NMDP submitted a letter to CMS regarding the Proposed Decision Memo for Chimeric Antigen Receptor (CAR) T-cell Therapy for Cancers to detail our concerns with regard to patient access and provide recommendations on coverage and registry requirements. Read the comment letter. (2019)
NMDP, CIBMTR, and ASMBT wrote a joint letter to CMS to advocate for CAR-T coverage and to ensure CMS understands the patient access issues that a National Coverage Determination for CAR-T could cause. Read the NCA CAR-T Comment Letter. (2018)
The Health Policy team served a critical role in the expansion
of Medicare coverage for these three indications in the Coverage with Evidence
Development (CED) paradigm. Read the Decision Memo for Stem Cell Transplantation (Multiple Myeloma, Myelofibrosis, and Sickle Cell Disease). (2016)