Morning Briefing
Summaries of health policy coverage from major news organizations
Official Tells Hill Panel Medicare May Revise Controversial Drug Payment Proposal
The New York Times: Latest Plan To Cut Medicare Drug Payments Leaves Senators Skeptical
Under fire from senators in both parties, a senior federal health official told Congress on Tuesday that the Obama administration would adjust its plan to reduce Medicare payments for many prescription drugs, but those assurances did not fully allay deep concerns. The official, Dr. Patrick H. Conway, a deputy administrator of the Centers for Medicare and Medicaid Services, indicated to the Senate Finance Committee that the administration would probably go ahead with its proposal in some form, and he promised that officials would try to prevent any harm to patients. (Pear, 6/28)
The Wall Street Journal: Medicare Proposal To Discourage Expensive Drugs May Undergo Changes
The response is an acknowledgment of the fierce backlash from lawmakers, doctors and patient groups who fear the proposal is too broad and will limit seniors’ access to drugs. Pressed by lawmakers, Dr. Conway remained vague about what could be changed but did say that re-examining the scope of the test proposal is a key issue. The goal of the plan is to remove the financial incentive for prescribing more expensive drugs. (Armour, 6/28)
The Associated Press: Medicare Weighs Changes To Controversial Plan On Cancer Meds
Affected [by the proposal] are those medications administered in a doctor's office. That includes most chemotherapy drugs, as well as injected and infused drugs for macular degeneration, rheumatoid arthritis, some immune diseases and other conditions. ... Medicare now pays doctors and hospital outpatient clinics the average sales price of a drug, plus a 6 percent add-on. Since 6 percent of a $15,000 drug is more than 6 percent of a $3,000 drug, some experts believe the formula influences doctors' prescribing decisions. The new formula would combine a 2.5 percent add-on with a flat fee for each day the drug is administered. A control group of doctors and hospitals would continue to be paid under the current system. (Alonso-Zaldivar, 6/28)
Modern Healthcare: CMS Defends Medicare Part B Proposal
The CMS has noted the concern for small and rural practices and has proposed a monitoring plan and potential exceptions to the rule, Conway said. He added that he is contacted daily by beneficiaries who currently have problems affording drugs prescribed to them. “If we think the status quo is optimal, I think we are mistaken, and we need to test new models,” he said. (Muchmore, 6/28)
Morning Consult: HHS Official Hints At Changes To Medicare Payment Proposal
Although Democrats have stopped short of embracing the proposal, they used the hearing to hammer home the point that something must be done about rising drug costs. If it’s not the administration’s proposal, it should be a different one. Sen. Ron Wyden (D-Ore.), ranking member of the committee, asked Conway if the rising costs threaten the sustainability of Medicare. “The costs of the Medicare program have the potential to threaten the program, and drugs are a substantial part of those costs,” Conway said. “I think we have to make major positive changes in the delivery system reform.” (Owens, 6/28)
The Hill: Obama Official Pledges 'Adjustments' To Controversial Medicare Proposal
Lawmakers on both sides of the aisle have expressed serious concerns with the administration’s proposal, which aims to fight high drug prices by changing the way Medicare Part B pays for drugs. ... Sen. Ron Wyden (D-Ore.), the top Democrat on the Senate Finance Committee, on Tuesday raised a common objection, that patient access to drugs could be harmed if doctors’ costs for a drug became higher than what Medicare reimbursed, especially in rural or small practices. (Sullivan, 6/28)
And in other Medicare news —
Kaiser Health News: HHS Proposes To Streamline Medicare Appeals Process
The Department of Health and Human Services Tuesday proposed key changes in the Medicare appeals process to help reduce the backlog of more than 700,000 cases. The measures “will help us get a leg up on this problem," said Nancy Griswold, chief law judge of the Office of Medicare Hearings and Appeals. If there was not a single additional appeal filed and no changes in the system, it would take 11 years to eliminate the backlog, Griswold said in an interview. (Jaffe, 6/29)
Health News Florida: Senate Budget Eliminates Funding For Medicare Counselors
A program that helps seniors choose a Medicare program and save money on prescription drugs could be going away in Florida and across the country. (Miller, 6/27)
Houston Chronicle: Three Doctors Convicted In $3.1 Million Scheme To Defraud Medicare
After two weeks of testimony and two full days of deliberation, the jury before U.S. District Judge Lynn N. Hughes convicted the three doctors of signing off on bogus exams for elderly and disabled patients who got kickbacks to visit the clinics and report vague symptoms. (Banks, 6/28)
