CMS will not finalize Medicare Part B payment proposal

A CMS spokesperson told American Hospital Association News Now the agency will not finalize Medicare Part B’s payment proposal during President Barack Obama’s administration, according to an AHA News Now press release.

Advertisement

In March 2016, CMS proposed a new payment method for Medicare B drugs, which would try out payment methods in different geographic locations to compare results in various parts of the country. Some of the proposed changes included:

• Lowering the add-on payments from 6 percent to 2.5 percent with an additional $16.80 flat payment
• Decreasing or eliminating patient cost-sharing
• Analyzing physicians’ prescribing patterns to create decision-support tools to help provide patients with the safest and most appropriate drug choices

Various physicians and medical groups across the country fiercely opposed the proposal, saying it would limit patients’ access to the critical drugs they need.

A CMS spokesperson told AHA News Now, “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.”

More articles on coding & billing:
What will happen to bundled payments during Donald Trump’s presidency?
Motley Fool highlights 3 things Americans like, dislike in a health plan
ACA enrollment surges to 6.4M — 4 key notes

At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 11-13 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.

Advertisement

Next Up in ASC Coding, Billing & Collections

  • In December 2025, HHS, alongside the Labor and Treasury departments, proposed significant updates to healthcare price transparency rules.  Comments for…

  • Legislators in Tennessee have delayed a vote on a bill that would loosen the state’s certificate-of-need laws, the TimesNews reported…

Advertisement

Comments are closed.