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.”
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