Codes, Coverage & Capitol Hill: Fighting for CAR-T and other cell and gene therapies with Jugna Shah

Listen to the episode here.

We all get excited—and rightfully so—at the rapid advance of clinical medicine. New treatments, therapies, and drugs save lives. But when you work in the revenue cycle, you know that payment mechanisms can significantly lag new technologies.

When codes don’t exist, or reimbursement is woefully inadequate, you have to take action. Petition, sometimes at the highest levels of government.

Jugna Shah is fighting for improved coverage and reimbursement for CAR-T and other cell and gene therapies, a trip that recently took her all the way to Capitol Hill. On this episode she talks about exciting work underway to improve healthcare accessibility and reimbursement, shaking hands with popular politicians, and of course some can’t miss documentation and coding tips.

On this show we cover:

• Jugna’s mission and the mission of Nimitt Consulting
• CAR-T and other cell and gene therapies: Current reimbursement mechanisms, insurance and coverage issues, and regulatory guidance
• Jugna’s advocacy efforts at the recent White House Cell and Gene Therapy Forum
• What came out of the Forum and what’s next given the recent change in administration
• What hospitals can do today to receive appropriate reimbursement for these life-saving therapies (she offers up some great advice on setting appropriate charges, citing the regulations)
• Where are we with drug administration (i.e., coding of injections/infusions)