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Providers, drug manufacturers critique Medicare's proposed drug plan — 6 things to know

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Medicare proposed an alternative payment method for Medicare B drugs, inciting many providers and drug manufacturers to critique the proposal, according to The New York Times.

Here are six things to know:

1. Many cancer providers and drug manufacturers claim the proposal prioritizes savings over patients' access to treatment.

2. Through the proposal, Medicare is comparing drugs' effectiveness to the cost of comparable medications, which could have a substantial financial impact on the pharmaceutical industry.
https://www.beckersasc.com/asc-coding-billing-and-collections/medicare-to-test-alternative-payment-methods-for-prescription-drugs-6-insights.html

3. Various legislators say Medicare's proposal could restrict some of the sickest Medicare beneficiaries' access to care and refer to the proposal as "another troubling example of unelected bureaucrats making decisions behind closed doors."

4. The Obama administration claimed the proposal would not interfere with physicians' medical judgment or their ability to prescribe Part B drugs when appropriate.

5. On March 4, the Federal Register published a notice saying the Obama administration wants to require physicians and hospitals to participate in providing Part B drugs to Medicare beneficiaries in geographic areas selected for the proposal.

6. The Pharmaceutical Research and Manufacturers of America and the Biotechnology Innovation Organization, as well as Allen Lichter, MD, chief of the American Society of Clinical Oncology have criticized the proposal. Dr. Lichter said while drug prices are escalating, "Doctors did not create this problem, and it will not be solved by putting pressure on physicians."

More articles on coding & billing:
Connecticut lawmakers examine 6% ASC tax repeal legislation: 4 things to know
Medicare to test alternative payment methods for prescription drugs — 6 insights
How ASCs can demonstrate value to payers: 4 key concepts

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