On November 22, 2016, the Centers for Medicare & Medicaid Services (CMS) notified ASBMT that its application for separate specialty designation for those physicians practicing blood and marrow transplant was approved. ASBMT members can now request designation as hematopoietic cellular transplant and cellular therapy physicians. Additional details on how members should operationalize this change within their centers will be forthcoming in early 2017. A link to the CMS letter to ASBMT is provided here.
A provision within the Affordable Care Act required all payers in the insurance exchange to provide access to all providers identified as CMS-recognized specialists. Without the Cellular Therapy Physician specialty status, these plans were under no obligation to provide access to their members. Additionally, under the Medicare Access and CHIP Reauthorization Act (MACRA), physicians will be identified by specialty and compared to their peers based on outcomes and resource utilization. Without the Cellular Therapy Physician designation, HCT physicians would have been compared to general hematology/oncology physicians who may be managing less complicated patients.
Finally, University Hospital Consortium (UHC) RVU output comparisons will be more accurate, as they will no longer have to rely on reporting by academic medical centers to determine which providers are HCT physicians. In the future, UHC will be able to determine HCT provider status directly from the downloaded claims data.
This designation will help define the role of the HCT physician and the unique care required by your patients. The HCT field has long provided patient-centric multidisciplinary care and this specialty designation will be important in demonstrating those care patterns to national stakeholders.
As more information on how to change physician specialty designation within a hospital program becomes available, ASBMT will provide detailed instructions to the membership group on how to proceed. This effort was led by Drs. James (Jim) Gajewski, Sergio Giralt, Effie Petersdorf, and Chris Bredeson, with support from consultants Amanda Cassidy and Paul Rudolf.