Morning Briefing
Summaries of health policy coverage from major news organizations
Opposition Building On Capitol Hill To HHS Plan To Cut Medicare Payments For Some Drugs
The Hill: Medicare Battle Brewing On Capitol Hill
An Obama administration proposal aimed at fighting high drug prices is facing a backlash on Capitol Hill. Republicans say the pilot program that would change how Medicare pays for certain drugs should be scrapped, while congressional Democrats are expressing serious concerns and seeking changes, but generally do not want to terminate it completely. (Sullivan, 4/28)
Modern Healthcare: Senators Want To Halt Change To Medicare Part B Drug Pay
Senate Finance Committee members from both parties told the CMS on Thursday not to go forward with a Medicare Part B initiative to change how hospitals and doctors are reimbursed for outpatient drugs. The CMS announced the mandatory change last month to criticism from some doctors and insurers as well as the pharmaceutical lobby. The five-year pilot program borne out of the Center for Medicare and Medicaid Innovation would, starting this year, decrease the percentage of a drug's average sales price paid to providers from 6% to 2.5% while adding a flat payment of $16.80 per drug a day. (Muchmore, 4/28)
And more details are emerging about the government's plan for changing how Medicare pays doctors —
Kaiser Health News: FAQ: Medicare Lays Out Plans For Changing Doctors’ Pay
Federal officials have unveiled their roadmap to a revamped Medicare physician payment system designed to reward doctors and other clinicians for the quality of care delivered, rather than the quantity. The proposed regulation would replace a patchwork of programs that now govern physician payments in Medicaid. It would allow doctors to choose from a new menu of measures and activities that officials said would be tailored to the type of care clinicians provide in Medicare’s traditional fee-for-service program. (Carey, 4/29)
Modern Healthcare: How Medicare's Payment Overhaul Tries To Change How Docs Use Tech
Medicare's new system for paying physicians will kill off the so-called “meaningful use” regime the government has used for the past five years to judge whether the providers deserve to be rewarded for using electronic health records.But that doesn't mean Medicare will no longer hold physicians accountable for incorporating information technology into the practice of medicine. And physicians may still struggle to clear the bar, even though the law and the proposed rule issued by the CMS have made significant efforts to make the new framework less rigid and more valuable. (Rubenfire, 4/29)
Medscape: New Medicare Penalty Hits Small Groups, Solo Physicians Hardest
Medicare's new compensation formula will bestow performance bonuses as high as 4% on an estimated 412,000 physicians and other clinicians in 2019 and impose corresponding penalties on another 346,000, mostly in practices of from one to 24 members, according to proposed regulations released yesterday by the Centers for Medicare & Medicaid Services (CMS). One physician organization is expressing dismay about a payment system that seems to work against smaller practices. "It's extremely concerning," said Anders Gilberg, senior vice president of government affairs for the Medical Group Management Association (MGMA), in an interview with Medscape Medical News. "Any program like this should give physicians the opportunity to succeed regardless of practice size." (Lowes, 4/28)
