CMS Weighs in on Controversial Medicare Part B Proposal

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The Obama administration is reconsidering the scope of and payment formula behind a controversial proposal to remove Medicare’s profit incentives for doctors who administer drugs, an Obama administration official said Tuesday. (The Wall Street Journal)

Choosing his words carefully, Medicare Deputy Administrator Patrick Conway told the Senate Finance Committee his agency is looking closely at comments it has received, and officials will determine if any adjustments are needed before the plan is finalized. He said the areas Medicare is reviewing include the nationwide scope of the experiment, and its impact on rural areas and small medical practices. (ABC News)

Currently, Medicare pays doctors the average price of a drug plus 6 percent. The administration warns that system gives doctors an incentive to prescribe higher-cost drugs so that they get paid more. The pilot program would reduce the 6 percent add-on to 2.5 percent plus a flat fee of about $16.  (The Hill)

They say the change could put some drugs out of the reach of patients, particularly at small practices in rural areas that wouldn’t receive enough reimbursement to cover the cost of the drug. The proposal has also been criticized for failing to address the core issues surrounding high prescription drug prices. (Modern Healthcare)

Read more:

Medicare Part B Drug Pay Plan Stirs Opposition

CMS Willing to Revise Part B Drug Pay Plan

 

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