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CMSRulemakingCMS-2016-0036

Medicare Program; Part B Drug Payment Model (CMS-1670-P)

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Medical Imaging & Technology Alliance filings
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Medical Imaging & Technology Alliance filed 1 comment on this docket between May 11, 2016 and May 11, 2016. 115 other organizations filed here. The comment window closed 3732d ago.

What Medical Imaging & Technology Alliance filed (1)

May 11, 2016· VA -- Medical Imaging & Technology Alliance (MITA)· CMS-2016-0036-0934

Filed on regulations.gov — full text not in the inline record.

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Abstract

This proposed rule discusses the implementation of a new Medicare payment model under section 1115A of the Social Security Act (the Act). We propose the Part B Drug Payment Model as a two-phase model that would test whether alternative drug payment designs will lead to a reduction in Medicare expenditures, while preserving or enhancing the quality of care provided to Medicare beneficiaries. The first phase would involve changing the 6 percent add-on to Average Sales Price (ASP) that we use to make drug payments under Part B to 2.5 percent plus a flat fee (in a budget neutral manner). The second phase would implement valuebased purchasing tools similar to those employed by commercial health plans, pharmacy benefit managers, hospitals, and other entities that manage health benefits and drug utilization. We believe this model will further our goals of smarter, that is, more efficient spending on quality care for Medicare beneficiaries

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