CMS proposes Part B changes

CMS proposed a rule that would change the traditional "buy and bill" model for Medicare Part B drugs to remove an incentive for physicians to prescribe expensive medicines over cheaper, equally effective alternatives.

Under the current model, physicians who buy a drug from its manufacturer are reimbursed by CMS at the average sales price (ASP), plus 6%. The proposed rule would change this to ASP plus 2.5%, plus a $16.80 administration fee. The flat fee would be calculated to be budget neutral in aggregate, the agency wrote, noting that "CMS intends for the test to result in savings through changes in prescribers' behavior." ...