Issue Background

Medicare Part B Drug Reimbursement

Where We Stand

  • CMS issued a new proposed rule on Part-B drug reimbursements on March 8
  • Among the proposed models in the rule, would be a reduction in reimbursement from ASP+6 to ASP+2.5 & $16.80 per day
  • Comments on the rule will be open until May 9

On March 8, 2016, the Centers for Medicare and Medicaid Services (CMS) released a proposal to test new Medicare Part B prescription drug models. The proposed rule and models were designed to address prescription drug spending.

For rheumatologists and their patients, the proposed rule is troubling. Higher cost medications, such as the biologic drugs used by many rheumatologic patients would be disproportionately impacted by the proposed rule. This could lead to a lack of access to these drugs for patients across the country.

Other items in the CMS document do appear to be more measured, such as a possible model looking at decreasing the cost sharing requirements for patients.

CMS has issued a 60-day comment period on the full proposed rule. Comments are due by May 9, 2016.CSRO is still reviewing the 119 page document, and will be providing additional feedback and information on ways to make the rheumatology voice heard on this issue.

For Patients:

Sign The Petition!

For Physicians:

Write a Letter

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