AHA today urged the Centers for Medicare & Medicaid Services to immediately withdraw its Most Favored Nation model interim final rule and “replace it with a serious effort at drug pricing reform.” 

Effective Jan. 1 for most hospitals, the interim final rule cuts payments for certain Medicare Part B drugs and biologicals to no more than the lowest price that drug manufacturers receive in other similar countries.  

“Instead of directly tackling the skyrocketing cost of drugs, this rule puts hospitals in the untenable position of having to divert resources from other patient care simply to buy the drug therapies they need for their patients,” AHA wrote. “And instead of enacting thoughtful policies that attempt to lower drug prices, this rule puts patients at risk. Indeed, CMS itself states that it expects beneficiaries’ access to drugs to be impeded, requiring them to accept less-effective treatments or forgo or postpone necessary care. In addition, the agency makes the breathtaking estimate that, within three years, nearly one in five Medicare Part B enrollees may have no access to drugs subject to the MFN rule.”

The AHA last month filed a declaration supporting other organizations seeking a temporary restraining order and preliminary injunction to prevent the rule from cutting payments for certain Medicare Part B drugs and biologicals. 

Perspective
Public
Approximately 35 million Americans are enrolled in Medicare Advantage plans in 2026, and that number is expected to grow to about 45 million MA enrollees by…
Headline
The Centers for Medicare & Medicaid Services has released details on downloading its upcoming fiscal year 2025 Program for Evaluating Payment Patterns…
Headline
The Department of Health and Human Services Administration for Community Living has launched the first phase of its Health at Home Challenge, a competition to…
Headline
The AHA shared the following statement with the media in response to a report released May 7 by Families USA.   “This report is long on rhetoric and…
Headline
The AHA May 7 wrote to House and Senate lawmakers in support of the Medicare Advantage Improvement Act (H.R. 8375/S. 4384), bipartisan and bicameral…
Headline
The Centers for Medicare & Medicaid Services announced May 6 that it will provide access to certain glucagon-like peptide-1 (GLP-1) medications to eligible…