Late last month, the Centers for Medicare & Medicaid Services (CMS) released an advance notice of proposed rulemaking (ANPRM), seeking feedback on a potential drug pricing model called the International Pricing Index (IPI) model. This comment solicitation is in alignment with the administration’s blueprint to lower drug costs and reduce out-of-pocket costs, and is an opportunity for public comment before a proposed rule is issued. The CMS is considering issuing a proposed rule in the spring of 2019, while the potential IPI model would start in spring 2020 and operate for five years. The ACR is evaluating the model and potential impacts on rheumatology practices and patient access, and is soliciting member feedback to incorporate in comments.
Potential Model Components
The CMS is interested in public comments regarding several potential model components, including:
- Phasing down the Medicare payment amount for selected Part B drugs to more closely align with international prices;
- Allowing private-sector vendors to negotiate prices for drugs, take title to drugs, and compete for physician and hospital business; and
- Changing the 4.3% (post-sequester) drug add-on payment in the model to reflect 6% of historical drug costs translated into a set payment amount.
Over the course of the model, the CMS plans to monitor and evaluate the impact of the model on beneficiary access to drugs, program costs, and the quality of care for beneficiaries. Download the ANPRM from the CMS Newsroom.
Give Us Your Feedback
The ACR is analyzing the potential impact of such a model on rheumatology practices and patient access to treatment. The ACR will submit comments on or before Monday, Dec. 31, 2018. If you have feedback on this advance notice specifically, we welcome your comments by email to [email protected].