Medicare Advocates Submit Statement on Part B Prescription Drug Model

This week, the Medicare Rights Center, along with a coalition of 20 organizations sent a letter expressing support for the mission and goals of the Centers for Medicare & Medicaid Innovation (CMMI), including the proposed Part B Drug Payment Model. CMMI is the part of the Centers for Medicare & Medicaid Services (CMS) tasked with developing and evaluating ways to make the Medicare program more value-driven, more efficient, and more effective at delivering and paying for needed care.

Through the Part B Drug Payment Model, CMMI recently proposed to alter the way that doctors are paid for medications that they supply and administer to Medicare beneficiaries. The goal of the proposal is to address payment incentives that may lead some providers to prescribe higher cost medications rather than lower cost, equally effective alternatives. This proposal is part of a broader movement away from simple fee-for-service structures, which pay for care based on the volume of services provided, and towards a health care system that rewards efficient, high quality care.

The coalition letter expresses support for these broad transformations and highlights the importance of ensuring that beneficiaries needs are met throughout the transition to value-based payment models. Enhanced educational efforts, stringent monitoring, and close oversight are needed to make certain that changes to payment models do not disrupt access to care. With adequate protections, however, changes like those tested by CMMI are essential to ensuring the future stability and health of the Medicare program.

Read the letter.