What is Medicare’s NCTAP?
CMS has established a new COVID-19 Treatments Add-on Payment (NCTAP) under the Medicare Inpatient Prospective Payment System (IPPS). The NCTAP was designed to mitigate potential financial disincentives for hospitals to provide new COVID-19 treatments. Through the NCTAP, the Medicare Program will provide an enhanced payment for eligible inpatient cases that use certain new products with current FDA approval or emergency use authorization (EUA) to treat COVID-19. NCTAP claims are those that are eligible for the 20% add-on payment.
- 65% of the operating outlier threshold for the claim
- 65% of the amount by which the costs of the case exceed the standard Diagnosis-Related Group (DRG) payment
- EUA for the use of COVID-19 convalescent plasma for treating COVID-19 in hospitalized patients
- Also known as “survivor’s plasma,” contains antibodies, or special proteins, generated by the body’s immune system to the novel coronavirus. More than 100,000 people in the United States and many more worldwide have already been treated with it since the pandemic began
- If hospitalized patients with COVID-19, early in the course of disease, and those hospitalized with impaired humoral immunity
- FDA approved remdesivir (Veklury) for the treatment of COVID-19 for adults and certain pediatric patients requiring hospitalization
- It is reasonable to believe that Veklury may be effective in treating suspected or laboratory-confirmed COVID-19 in hospitalized pediatric patients weighing 3.5 kg to less than 40 kg or hospitalized pediatric patients less than 12 years of age weighing at least 3.5 kg
- EUA for the use of baricitinib (Olumiant), in combination with remdesivir (Veklury), for the treatment of suspected or laboratory confirmed COVID-19 in certain hospitalized patients
- hospitalized adults and pediatric patients 2 years of age or older requiring supplemental oxygen, non-invasive or invasive mechanical ventilation, or ECMO
We continue to see more advances with respect to Medicare and new treatments. Please watch this space as the innovations more forward.
Our Editorial Note: Above is our summary of a recent update on Medicare, it is not meant to be complete or show the entirety of changes. Contact us if you would like to learn more about regenerative medicine and how it may help patients with Covid-19 and other medical conditions.