ABIOMED, Inc. (NASDAQ:ABMD) Files An 8-K Other Events
Item8.01
| Other Events. |
Current hospital reimbursement for Calendar Year 2017,
Abiomed Fiscal Year 2018
MS-DRG 215, Heart Assist System Implant, was recently confirmed
for an Impella catheterization lab implant and ICU care in
October 2016 through an update by the American Hospital
Association (AHA) Coding Clinic publication.In addition to the
October 2016 update, a recent AHA Coding Clinical publication in
March 2017 added clarification of coding for implant of
bi-ventricular Impella heart support along with the removal of
the device provides hospital payment in MS-DRG 1 or 2 depending
upon severity of illness.
Abiomeds Impella technology is now most commonly reimbursed under
four MS-DRG categories including: 1) assistance in the
catheterization lab only in MS-DRGs 216-221; 2) implant,
assistance and removal after leaving the catheterization lab in
MS-DRG 215; 3) right and left side heart support known as
bi-ventricular and removal in MS-DRG 1-2, and; 4) hospitals
receiving transferred patients with removal of the device in
MS-DRG 268-269.In prior years, Impella was primarily reimbursed
in only one category of MS-DRGs 216-221.The American Hospital
Association (AHA) and Centers for Medicare and Medicaid Services
(CMS) have facilitated a system of care around the utilization of
percutaneous heart pumps for the catheterization lab, ICU
support, and transfer of patients to specialized centers. This
progress also represents the expansion of Impella FDA indications
for High Risk PCI, AMI Cardiogenic Shock, and bi-ventricular
support.
Table A. Summary of common MS-DRGs for illustration
only.
|
Common Impella Procedures* |
MS-DRG | CurrentRate (Sample100Impella sites) | CurrentRate (AllHospitals) | |||||||||
|
Impella assistance in catheterization lab only |
$ | 70,299 | $ | 57,460 | ||||||||
|
Impella implant with care after catheterization lab |
$ | 117,413 | $ | 95,971 | ||||||||
|
Biventricular implant |
$ | 197,548 | $ | 161,472 | ||||||||
|
ICU care and removal of Impella, after transfer from |
$ | 45,957 | $ | 37,564 |
| * | Actual MS-DRGs may vary based on procedure. |
Examples
provided with Major Comorbidity or MCC.
All Hospitals
include 3,405 medicare hospitals, and only approximately 1,400
have cath labs or operating rooms. Sample includes 100 Impella
sites.
Centers
for Medicare and Medicaid Services (CMS) Proposed Rule for the
Inpatient Prospective Payment System (IPPS)
On Friday,
April14, 2017, the Centers for Medicare and Medicaid Services
(CMS) released a draft of hospital payment levels proposed for
patient discharges after October1, 2017.The Proposed Rule for the
Inpatient Prospective Payment System (IPPS) is available on the
CMS website at cms.gov and is open for public comment until
June13, 2017.All discharges prior to October1, 2017 would remain
under the current payment levels, and the final rulemaking is
expected to be released in August 2017.The final rulemaking may
differ substantially from this proposal.
The text of the
Proposed Rule did not discuss any specific information relating
to payment, coding or MS-DRG assignments for Impella,
percutaneous heart assist, or related technology.Data tables also
released with the Proposed Rule include changes for all MS-DRGs
which included a proposed reduction for MS-DRG 215 of 34.8%. The
remaining MS-DRG categories have proposed changes ranging from
-7% to 3.5%.All current MS-DRG rates will remain in
place until October 2017.
Table B. Summary of common
MS-DRGs from the Proposed Rule for illustration
only.
|
Common Impella Procedures* |
MS-DRG | ProposedFY2018Rate (Sample100Impella sites) | ProposedFY2018Payment (All Hospitals) | |||||||||
|
Impella assistance in catheterization lab only |
$ | 69,455 | $ | 57,622 | ||||||||
|
Impella implant with care after catheterization lab |
$ | 76,525 | $ | 63,487 | ||||||||
|
Biventricular implant |
$ | 183,776 | $ | 152,464 | ||||||||
|
ICU care and removal of Impella, after transfer from |
$ | 47,580 | $ | 39,474 |
| * | Actual MS-DRGs may vary based on procedure. |
Examples provided with
Major Comorbidity or MCC.
All Hospitals include
3,405 medicare hospitals, and only approximately 1,400 have cath
labs or operating rooms. Sample includes 100 Impella
sites.
A new formula for calculating
all Medicare MS-DRG base weights, the calculation used to
determine hospital payment level, was described in the Proposed
Rule.However, no Impella patient claim data related to the change
in the October 2016 American Hospital Association (AHA) Coding
Clinic publication was included in the analysis for the proposed
MS-DRG rate changes.Abiomed is reviewing the detailed data within
the tables and will be discussing the appropriate DRG rates with
CMS during the open comment period to confirm it accurately
reflects the hospital resources required to treat these very ill
patients.
About ABIOMED, Inc. (NASDAQ:ABMD)
ABIOMED, Inc. is a provider of temporary percutaneous mechanical circulatory support devices. The Company offers care to heart failure patients. The Company operates in the segment of the research, development and sale of medical devices to assist or replace the pumping function of the failing heart. The Company develops, manufactures and markets products that are designed to enable the heart to rest, heal and recover by improving blood flow to the coronary arteries and end-organs and/or temporarily performing the pumping function of the heart. The Company’s product portfolio includes the Impella 2.5, Impella CP, Impella RP, Impella LD, Impella 5.0 and AB5000. The Company’s products are used in the cardiac catheterization lab (cath lab), by interventional cardiologists, the electrophysiology lab, the hybrid lab and in the heart surgery suite by heart surgeons. ABIOMED, Inc. (NASDAQ:ABMD) Recent Trading Information
ABIOMED, Inc. (NASDAQ:ABMD) closed its last trading session down -0.87 at 124.61 with 144,238 shares trading hands.
