Industry groups, doctors ask CMS to withdraw proposed Part B experiment
- Over 100 industry and physician groups have signed a letter urging the Department of Health and Human Services to withdraw a proposed Medicare Part B experiment which was accidentally leaked online earlier this year.
- The proposed revision would vary Part B drug reimbursement payments to doctors by geographic location, aiming to determine whether the current system incentivizes doctors to prescribe more expensive drugs.
- Both PhRMA and BIO, two heavyweight pharmaceutical trade organizations, signed onto the letter.
The proposed plan, known as the Medicare Part B Drug Payment Model, was accidentally leaked in early February on the Centers for Medicare and Medicaid (CMS) website. It asked Medicare contractors to establish a system allowing the government to vary reimbursement payments by geographic location, such as by zip code. This ability would enable CMS to test whether limiting payments changes doctors’ prescribing behavior.
However, an industry coalition of over 100 groups argues such a program would ignore the unique needs of patients and potentially restrict the ability of some patients to get needed treatments.
“We believe that this type of initiative, implemented without sufficient stakeholder input, will adversely affect the care and treatment of Medicare patients with complex conditions, such as cancer, macular degeneration, hypertension, rheumatoid arthritis, and primary immunodeficiency diseases,” the groups wrote.
The groups called for greater transparency and opportunity for input into CMS’ planned reforms, as well as the withdrawal of the planned project.