CMS does not plan to finalize a proposed rule that would test new Medicare Part B payment models, according to Politico.
Medicare Part B covers prescription drugs administered in a physician's office or hospital outpatient department. The proposed rule was intended to test alternative drug payment structures to help reduce costs and improve patient outcomes. However, after receiving industry feedback, CMS decided to cancel the demo.
"After considering comments, CMS will not finalize the Medicare Part B Drug Payment Model during this administration," a CMS spokesman told Politico.
Through the proposed rule, CMS sought to achieve savings and improve quality by changing prescribing incentives. Physicians and outpatient departments are typically paid the average sales price of a drug, plus a 6 percent add-on. The proposed rule called for changing the add-on payment to 2.5 percent plus a flat fee payment of $16.80 per drug per day. CMS said the current payment methodology can penalize physicians for selecting lower-cost drugs, even when these drugs will achieve as good or better patient outcomes than higher-priced alternatives.
CMS received comments from many concerned stakeholders about the proposal. "While CMS was working to address these concerns, the complexity of the issues and the limited time available led to the decision not to finalize the rule at this time," a CMS spokesperson told AHA News Now.
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