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ASCRS and Medical Community Advocacy Prompts CMS to Formally Withdraw Part B Drug Demonstration

Following advocacy efforts of ASCRS and the medical community, the Centers for Medicare and Medicaid Services (CMS) announced this week that they will formally withdraw the Center for Medicare & Medicaid Innovation (CMMI) proposed rule relating to the "Medicare Part B Drug Payment Model." The proposed rule would have limited the use of high-cost drugs by changing the way it reimburses physicians for drugs administered in office. Instead of the current average sales price, plus 6% now reimbursed to physicians, the proposal would lower the additional percentage to 2.5% and include a $16.80 additional flat fee. ASCRS and the medical community strongly opposed the proposed Part B drug demonstration due to the nationwide scope and that it could limit patient access to needed treatments solely based on price. Previously, CMS said they would put the implementation of this rule on hold, but this week’s announcement formally removes the proposal.

As previously reported, CMMI has issued a Request for Information (RFI) to gather input from stakeholders on new Medicare and Medicaid payment models, including for drug payment. ASCRS is planning to submit comments, and we will stress the importance of preserving access to care and needed treatments for Medicare beneficiaries. We will keep you updated.