Doc groups happy to see mandatory drug demo nixed

Money Pills
Doctors applauded a government decision to cancel a pilot program aimed at cutting Medicare Part B drug costs.

The cancellation of a pilot program, which would have been mandatory for all providers and suppliers that furnish and bill for Medicare Part B drugs, was welcome news for physicians.

Numerous organizations applauded the Centers for Medicare & Medicaid Services' decision to cancel its proposed five-year Part B payment model demonstration. The model would have created incentives for patients and physicians to select lower-cost, high-performing drugs that are administered at medical facilities.

RELATED: CMS nixes Medicare Part B demonstration

The Medical Group Management Association (MGMA) said the proposal would not have tackled the root cause of growing Part B drug costs, which it said are set by manufacturers. “Our primary concern was it would force physician practices to either write off losses from below-cost drug reimbursements to physicians or send patients to more expensive hospital outpatient departments for life-saving treatments such as chemotherapy,” said MGMA’s president and CEO Halee Fisher-Wright, M.D.

Of particular concern of opponents was the impact on cancer patients. The Community Oncology Alliance, a non-profit organization that advocates for community oncology practices, also welcomed the news. “Cancer patients and their providers across the country can breathe a sigh of relief now that the Part B experiment on cancer care is finally dead,” said Ted Okon, executive director, in an announcement.

Rheumatologists were also vocal opponents of the demonstration because of concerns that it would negatively and disproportionately impact their patients’ ability to access biologic therapies. The American College of Rheumatology said the decision is good news for rheumatology patients who rely on Medicare Part B to access life-saving biologic therapies.

“For older Americans living with painful and debilitating diseases like rheumatoid arthritis, lupus, spondyloarthritis and psoriatic arthritis, safe access to biologic therapies is not an option but a necessity—which is why the ACR has been vocal in expressing our concerns about the unintended consequences of this proposal and its flawed cost-savings premise,” said Sharad Lakhanpal, M.D., president of the organization, in an announcement.

The American Medical Association also hailed CMS’ decision to scrap the demonstration entirely, saying it would hurt patient care.

Suggested Articles

A federal judge in Maryland has vacated CMS' 2019 rule that would require Affordable Care Act insurers to bill separately for abortions.

A lawsuit filed against Teladoc accuses the company of engaging a third party to sell telehealth subscriptions to consumers without their consent.

As COVID-19 led to significant increases in the demand for digital health, insurer Healthfirst accelerated the launch of its new app.