Lawmakers on both sides of the aisle are criticizing a federal proposal to reduce Medicare payments for many prescription drugs, The New York Times reported.
In March, CMS said it would test new Part B payment models to encourage physicians to select the most effective treatment for patients and to slow Medicare spending.
But patients' advocates, physicians and drug companies have warned the federal plan could threaten access to important medications used to treat various types of cancer, rheumatoid arthritis, macular degeneration and other conditions, according to the report. Republicans and Democrats on the Senate Finance Committee, along with more than 300 House members, have also expressed concern.
The advocacy arm of the American Cancer Society recently wrote a letter to HHS Secretary Sylvia Mathews Burwell, saying the proposal "does not protect cancer patients' access to the lifesaving drugs needed to treat their disease," and "focuses more on the potential for cost savings" than on ways to preserve and enhance quality, The New York Times reported.
The American Hospital Association weighed in on the proposal in early May. The AHA said the new model should not include hospitals, which "have little control over which drugs physicians prescribe in hospital-based settings." The AHA also took issue with the model's lack of quality measures, which it believes are critical to ensuring the drug payment model doesn't reduce quality of care.
As for the lawmakers, Republicans said President Barack Obama's administration should withdraw the proposal, according to the report. Many Democrats, citing high drug prices, said federal officials are making a worthy effort, but should not move ahead without doing more to protect beneficiaries.
While many entities have expressed concerns, some Democrats and consumer organizations have thrown support behind the proposal. For instance, AARP argued it could reduce out-of-pocket costs for beneficiaries.
The first phase of the new "payment model" could start as early Aug. 1, The New York Times reported. According to the report, the next phase, which could start as soon as January 2017, would involve Medicare linking payment to a drug's value. That could mean the federal government pays more for drugs that it deemed more effective in treating or preventing a specific condition, or paying the same amount for drugs that it saw as "therapeutically similar," the report states.
President Obama's administration said it wanted to require "mandatory participation" for physicians and hospitals that provide Part B drugs to Medicare beneficiaries in about three-fourths of the nation.
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