Add-On Payments for New Medical Services and Technologies Paid Under the Inpatient Prospective Payment System (IPPS) (CMS-10638)
Revision of a currently approved collection
No
Regular
09/20/2023
Requested
Previously Approved
36 Months From Approved
11/30/2023
62
62
1,655
1,655
0
0
Sections 1886(d) (5) (K) and (L) of the Act establish a process of identifying and ensuring adequate payment for new medical services and technologies (sometimes collectively referred to in this section as âânew technologiesââ) under the IPPS. Section1886(d)(5)(K)(vi) of the Act specifies that a medical service or technology will be considered new if it meets criteria established by the Secretary after notice and opportunity for public comment. Section 1886(d)(5)(K)(ii)(I) of the Act specifies that a new medical service or technology may be considered for new technology add-on payment if, ââbased on the estimated costs incurred with respect to discharges involving such service or technology, the DRG prospective payment rate otherwise applicable to such discharges under this subsection is inadequate.ââ
The regulations at 42 CFR 412.87 implement these provisions and specify three criteria for a new medical service or technology to receive the additional payment: (1) The medical service or technology must be new; (2) the medical service or technology must be costly such that the DRG rate otherwise applicable to discharges involving the medical service or technology is determined to be inadequate; and (3) the service or technology must demonstrate a substantial clinical improvement over existing services or technologies.
US Code:
42 USC 1395ww
Name of Law: Add-On Payments for New Medical Services and Technologies Policy
The total hourly burden for all the applicants to fill out and answer questions for their applications will remain the same at 1,655 hours. This includes a total of 1,280 hours for applications on the traditional pathway and 375 hours for those in the alternative pathway.
For FY 2025, we are updating the NTAP MEARIS⢠application to further simplify or clarify existing application questions, including:
a) reorganizing the Coding, Cost, and Volume sections of the application to improve flow,
b) simplifying the FDA section questions and revising language for these questions to reflect policy changes effective for FY 2025,
c) simplifying the way applicants can include codes and MS-DRGs, and
d) adding additional explanatory notes in multiple sections of the application to improve understanding of the question.
These changes will not result in any net increase in burden for applicants.
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.