Medicare Part B outpatient drug payment cancelled

The Center for Medicare and Medicaid Innovation will not move forward with a mandatory five-year Medicare initiative to test new ways of paying for outpatient drugs.

A Centers for Medicare and Medicaid Services spokesman announced the agency scrapped the program after reading more than 1,300 public comments, most of them negative.

“While the proposed Medicare Part B demonstration had admirable goals, our members raised a number of concerns, and we are pleased the Center for Medicare and Medicaid Innovation has decided not to move forward,” House Minority Leader Nancy Pelosi said in a statement.

The Part B demo program would have explored new ways to pay for drugs in an attempt to improve patient outcomes and cut costs. Medicare Part B reimburses 6 percent plus the average sales price of the drugs administered by infusion or injection in doctors’ offices and hospital outpatient departments. The agency proposed dropping the payment from 6 to 2.5 percent of a drug’s average sales price while adding a flat payment of $16.80 per drug a day.

Critics argued the current model incentivizes physicians to prescribe a more expensive medication while opponents argued the proposed pricing demonstration would have undermined physicians’ ability to care for patients and could pose a threat to patients’ safety. 

Topics: Medicare/Medicaid