Medicare Part B Drug Reimbursement Program Distresses Pharmacy Players Program Seeks to Reduce Use of Expensive Biologies

摘要

The new Medicare drug-pricing program aimed at cutting reimburse- ment for Part B drugs will hit hospitals hardest, according to the Centers for Medicare and Medicaid Services (CMS). The drugs at issue are typically chemotherapy, ophthalmic, or rheumatoid arthritis drugs infused in a physician's office or a hospital outpatient clinic. Medicare reimburses either the physician or the hospital-and sometimes a specialty pharmacy-under Medicare Part B. Very occasionally those drugs are paid for under the Part D outpatient drug program.The plan has proven controversial. Oncologists have led the charge to force the CMS to backtrack, and allies, both Republican and Democrat, in Congress have sent the CMS letters of opposition and, in at least one case, introduced Republican-sponsored legislation to thwart the plan. The AARP and parts of the insurance industry are trying to stiffen the CMS's spine.