CMS is focusing on drug payment policies—how will this manifest in 2019 rulemaking?

Why This Topic Matters

The piece helps providers anticipate policy changes that could affect hospital payment, administrative burden, and public reporting expectations. It is especially relevant for organizations following CMS proposals that may alter how drugs and drug-related services are paid under Medicare.

Article Sections

1. CMS drug payment policy priorities and the 2019 rulemaking landscape

   An overview of CMS’s attention to drug pricing and the main rulemaking and policy channels where providers may see related proposals.

2. Provider feedback, RFI timing, and proposed rule comment strategy

   Discussion of how the agency is seeking input and why hospitals and other stakeholders are being encouraged to participate in multiple comment opportunities.

3. Transparency, site neutrality, 340B, and packaging concerns

   A look at the broad policy themes that may affect payment levels, charge reporting, and administrative burden across hospital settings.

4. CAR-T payment, coding, and coverage questions

   Coverage, reimbursement, and coding issues surrounding CAR-T and the ways CMS appears to be approaching this emerging therapy area.

5. Looking ahead to OPPS rulemaking

   Expectations for outpatient policy changes in upcoming rulemaking, including potential shifts in reporting, payment structure, and other drug-related provisions.