In April, the Medicare Payment Advisory Committee voted to recommend a change in the add-on payment for Part B drugs, including reducing payment for more expensive drugs. The ACR sent a letter to MedPAC expressing concerns about the significant impacts such policies would have on rheumatologists.
ATLANTA—The American College of Rheumatology (ACR) today applauded the U.S. Centers for Medicare & Medicaid Services’ (CMS) decision to withdraw a proposed rule to implement the “Most Favored Nation” (MFN) payment model for Part B drugs. Leaders felt the policy would have dramatically disrupted patient access to critical therapies needed to manage rheumatic diseases and…
In August 2018, the Centers for Medicare and Medicaid Services (CMS) announced it would permit Medicare Advantage plans to use step therapy for Part B drugs, with a lookback period of just 108 days.1 On May 16, 2019, however, the CMS issued a final rule that extends the lookback period for Part B therapies to 365…
Recently, the Centers for Medicare and Medicaid Services (CMS) discovered an error in the implementation of the 2019 Merit-Based Incentive Payment System (MIPS) payment adjustment. It incorrectly applies adjustments to payments for Medicare Part B drugs and other non-physician services billed by physicians. Adjustments to affected claims will occur in the near future. According to the…