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This form is used by manufacturers to apply for new technology add-on payments under the Medicare Acute Inpatient Prospective Payment System, detailing the technology and associated clinical data.
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How to fill out tracking form for applicants

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How to fill out Tracking Form for Applicants for New Technology Add-on Payments under the Acute Inpatient Prospective Payment System (IPPS)

01
Gather all relevant information about the new technology being applied for.
02
Obtain the Tracking Form for Applicants for New Technology Add-on Payments from the appropriate CMS website or office.
03
Fill in the applicant's details, including name and contact information.
04
Provide a detailed description of the new technology, including its purpose and potential benefits.
05
Include data on how the technology improves the quality of care or patient outcomes.
06
Specify the costs associated with the new technology and any evidence of cost-effectiveness.
07
Attach any supporting documents or research studies relevant to the technology.
08
Review the completed form for accuracy and completeness before submission.
09
Submit the completed Tracking Form according to the instructions provided by CMS.

Who needs Tracking Form for Applicants for New Technology Add-on Payments under the Acute Inpatient Prospective Payment System (IPPS)?

01
Hospitals and healthcare providers looking to receive additional payments for new technologies under the IPPS.
02
Manufacturers of innovative medical technologies seeking reimbursement.
03
Health systems introducing new treatment options that can improve patient care.
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This payment system is referred to as the inpatient prospective payment system (IPPS). Under the IPPS, each case is categorized into a diagnosis-related group (DRG). Each DRG has a payment weight assigned to it, based on the average resources used to treat Medicare patients in that DRG.
The NTAP amount is paid once per discharge and not per product unit of new technology used; however, the total costs of the new technology (including multiple units) are part of the total case charges that go into the calcula- tion of both the eligibility for NTAP and the NTAP amount.
The total payment amount for a IVL case that qualifies for an NTAP will consist of the full MS-DRG payment + 65% of the difference between the reported cost of the discharge and the MS-DRG payment, up to a maximum of $3,666 per case. The NTAP payment amount is then added to the hospital assigned DRG payment.
INTRODUCTION. In 2001, the Centers for Medicare and Medicaid Services (CMS) introduced the New Technology Add-on Payment (NTAP) program to incentivize utilization of new inpatient technologies in the Medicare population.
An NTAP designation enables additional payment to hospitals above the standard Medicare Severity Diagnosis-Related Group (MS-DRG) payment amount. A product's NTAP designation lasts for no more than three years for a specific indication.
The total payment amount for a IVL case that qualifies for an NTAP will consist of the full MS-DRG payment + 65% of the difference between the reported cost of the discharge and the MS-DRG payment, up to a maximum of $3,666 per case. The NTAP payment amount is then added to the hospital assigned DRG payment.
To qualify for a new technology add-on payment, the technology must represent an advance that substantially improves, relative to technologies previously available, the diagnosis or treatment of Medicare beneficiaries.
Two new substances that received NTAP approval are Casgevy™ and Lyfgenia™. Both of these medications are gene therapies that have indications for the treatment of sickle cell disease and when used for this purpose their administration qualifies for a significant NTAP.

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The Tracking Form for Applicants for New Technology Add-on Payments under the Acute Inpatient Prospective Payment System (IPPS) is a tool used by healthcare providers to apply for additional payments for new technologies that improve patient care and outcomes beyond existing technologies.
Healthcare providers who are seeking additional payments for new technologies under the IPPS are required to file the Tracking Form. This typically includes hospitals and other inpatient care facilities.
The Tracking Form should be completed by providing accurate details about the new technology being applied for, including its description, the clinical benefits, and supporting data that demonstrates its effectiveness in patient care.
The purpose of the Tracking Form is to facilitate the evaluation and approval process for new technology add-on payments, ensuring that innovative treatments and technologies are recognized and reimbursed appropriately in the healthcare system.
Information reported on the Tracking Form should include the technology's name, description, intended use, clinical indications, data demonstrating clinical benefits, and any relevant supporting documentation that substantiates the request for additional payment.
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