CMS rule restricts Crohn's, ulcerative colitis patients access to infusion services, DHPA says

The Digestive Health Physicians Association issued a statement opposing CMS' Most Favored Nation rule because it potentially limits access to infusion services.

If the rule goes into effect, the changes could make providing infusion services cost prohibitive for practices. The rule cuts reimbursement by using the lowest price drug manufacturers receive in one of 22 countries.

James Weber, MD, DHPA president and board chair, said, "Hundreds of thousands of patients are treated in DHPA member practices with medications that would be subject to this complicated scenario that bases reimbursements on what it costs to acquire the drugs in another country."

DHPA is also concerned the rule threatens the viability of physician-owned medical practices. If the margins are too low for these practices to administer infusion services, patients could seek care in more expensive settings.

CMS skipped the normal notice-and-comment rulemaking process for the rule. The required comment period closes in late January. DHPA will take part in a nationwide demonstration opposing the rule Jan. 1.

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