Analytic Support of New Technology Add-On Payments (NTAPs)

KNG Health has provided technical assistance to several clients in their applications for special add-on payments under the Medicare Inpatient Prospective Payment System (IPPS) reserved for new technologies (NTAPs), totaling 14 applications. Using Medicare inpatient claims, we identified the patient population likely to receive the new technology, grouped these cases into MS-DRGs, and calculated inflated standardized charges for those patients. The process of standardizing charges involves effectively reversing the policy adjustments included in the IPPS, including the wage index, cost-of-living adjustment, teaching adjustment, and DSH adjustment.  Charges were then compared to DRG-specific thresholds published by CMS to determine if charges in the population exceeded these thresholds. The IPPS Impact File was used to exclude providers not paid under IPPS and to remove hospital-specific payment adjustments to generate a standardized charge. We drafted reports of the results and methods for the NTAP application, and we provided ongoing support to the clients as they responded to comments in CMS’ Notice of Proposed Rulemaking.

Services : Payment Policy & Delivery System Innovation Expertise: ,