Memorial Sloan Kettering Cancer Center in New York City. Photo: Smith Collection / Gado via Getty Images

Lobbyists representing cancer hospitals are urging Medicare officials to create a new set of payments for new, expensive CAR-T treatments.

Looking ahead: Medicare is expected to release a big annual payment rule any day now, and there's a chance it could propose "add-on" payments for CAR-T therapies — a move that would cost the government millions of dollars while immediately broadening dying cancer patients' access to promising new treatments.

The details: Federal meeting records show four lobbyists working on behalf of cancer hospitals like Memorial Sloan Kettering Cancer Center and MD Anderson met with Medicare officials in February — including Demetrios Kouzoukas, a top Medicare director in the Trump administration — to talk about the proposed inpatient payment rule that is released every April.

Specifically, they discussed Medicare's payment policies for CAR-T, a therapy that attacks cancer by using a patient's own immune cells. Two CAR-T treatments have gotten FDA approval:

  • Kymriah, made by Novartis, has a list price of $475,000.
  • Yescarta, made by Gilead Sciences, has a list price of $373,000.

The rub: Medicare has approved outpatient rates for CAR-T at the standard price plus 6%, but the cost of inpatient CAR-T treatments is rolled into smaller bundled amounts that encompass the entire hospitalization.

Why it matters: Cancer doctors have only been comfortable providing CAR-T on an inpatient basis because the treatment is still new and patients need to be monitored closely for adverse reactions.

  • Many hospitals "would like to start the program, but not without adequate reimbursement from Medicare," said one person familiar with the industry, adding that Medicare officials "know it's a problem."

Go deeper: Bloomberg profiled CAR-T insurance hurdles in December.

Go deeper

Updated 41 mins ago - Politics & Policy

Supreme Court denies Pennsylvania GOP request to limit mail-in voting

Protesters outside Supreme Court. Photo: Daniel Slim/AFP via Getty Images

The Supreme Court on Monday denied a request from Pennsylvania's Republican Party to shorten the deadlines for mail-in ballots in the state. Thanks to the court's 4-4 deadlock, ballots can be counted for several days after Election Day.

Why it matters: It's a major win for Democrats that could decide the fate of thousands of ballots in a crucial swing state that President Trump won in 2016. The court's decision may signal how it would deal with similar election-related litigation in other states.

Microphones will be muted during parts of Thursday's presidential debate

Photos: Jim Watson and Saul Loeb/AFP via Getty Images

The Commission on Presidential Debates adopted new rules on Monday to mute microphones to allow President Trump and Joe Biden two minutes of uninterrupted time per segment during Thursday night's debate, AP reports.

Why it matters: In the September debate, Trump interrupted Biden 71 times, compared with Biden's 22 interruptions of Trump.

Updated 2 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Annelise Capossela/Axios

  1. Politics: Trump says if Biden's elected, "he'll listen to the scientists"Trump calls Fauci a "disaster" on campaign call.
  2. Health: Coronavirus hospitalizations are on the rise — 8 states set single-day coronavirus case records last week.
  3. States: Wisconsin judge reimposes capacity limit on indoor venues.
  4. Media: Trump attacks CNN as "dumb b*stards" for continuing to cover pandemic.
  5. Business: Consumer confidence surveys show Americans are getting nervousHow China's economy bounced back from coronavirus.
  6. Sports: We've entered the era of limited fan attendance.
  7. Education: Why education technology can’t save remote learning.