Healthcare News: MedPAC suggests overhaul of Part B drug payment policy in June report

June 30th, 2017

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This news article covers Medicare Payment Advisory Commission (MedPAC) recommendations to revise Medicare Part B drug payment policy. It focuses on the Commission’s concerns about rising spending, pricing competition, and reimbursement structure, then outlines broad categories of proposed changes to the average sales price (ASP) framework and a new voluntary payment model discussed for future implementation. The article is relevant to providers, coders, revenue cycle professionals, and others tracking Medicare drug payment policy and CMS payment-model development.

Why This Topic Matters

Medicare Part B drug payment policy affects reimbursement, beneficiary cost sharing, and how providers bill for drugs and biologics. Understanding MedPAC’s recommendations helps healthcare stakeholders follow potential CMS policy changes and anticipate future payment-model shifts.

What You Will Learn

  • Why MedPAC is reviewing Medicare Part B drug payment policy
  • The policy issues MedPAC says are affecting drug spending and price competition
  • The general types of changes proposed for the ASP-based payment framework
  • The concept of a proposed voluntary drug payment model for Part B products
  • How CMS proposals and MedPAC recommendations are related over time

Who Should Read This

  • Medical coders
  • Billing and reimbursement professionals
  • Revenue cycle teams
  • Healthcare administrators
  • Medicare policy analysts
  • Providers and practice managers

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