According to a proposal released Tuesday by the Centers for Medicare & Medicaid Services, Medicare is proposing a new payment model for Medicare’s Part B program for prescription medications within doctor’s offices and hospital outpatient centers. The change in the payment model is focused on preventing the prescribing of more expensive medications, since there are other prescriptions that are of the same quality at lower prices. The first part of the proposal that would be implemented at a later date this year will enforce a payment of the average price of the drug plus a 2.5%, compared to the current payment of the average sales price plus 6%. In addition to the 2.5% payment, doctors and medical outpatient centers will receive a flat fee of $16.80 per drug per day.
In the proposal’s second part, which would roll out in 2017, Medicare proposes to test multiple payment models, including payments based on the effectiveness of a drug for a particular condition. Medicare also wants to try to decrease or remove patient copayments for high-value medications.
To read more on this topic, view the original article from Kaiser Health News here.
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