New ways to skin the cat

The Centers for Medicare & Medicaid Services (CMS) continued to put the squeeze on the prices it will pay for drugs and biologics last week with its draft rule for the hospital outpatient prospective payment system (OPPS) for 2005.

Although there were few surprises, CMS does appear to be moving away from its "pass-through" payment system for recently approved medicines, which, in the absence of market pricing data, based reimbursement on a hospital's acquisition cost. The agency will employ a new reimbursement methodology for pass-through drugs whose status expires in 2005, which in effect will eliminate all "transitional" pass-through payments. ...