Administration will not finalize Medicare Part B drug payment model

The Centers for Medicare & Medicaid Services does not plan to finalize a proposed rule to test new models for how Medicare Part B pays for prescription drugs provided in physician offices and hospital outpatient departments. “After considering comments, CMS will not finalize the Medicare Part B Drug Payment Model during this Administration,” a CMS spokesman told AHA News Now. “The proposal was intended to test whether alternative drug payment structures would improve the quality of patient care and the value of Medicare drug spending. While there was a great deal of support from some, a number of stakeholders expressed strong concerns about the Model. 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. We appreciate the robust dialogue with our stakeholders on this important topic and value the feedback on this proposal and other CMMI models.” AHA supports finding ways to rein in rapidly rising drug prices, but expressed concerns with the proposed payment model and its inclusion of hospitals, which have little control over which drugs physicians prescribe in hospital-based settings.