CHICAGO — A proposal by the Centers for Medicare & Medicaid Services (CMS) to change the way Medicare pays for drugs under the Part B program would hurt physician practices, the American Medical Association said at its annual meeting here.
“This is a patient care issue and an access issue,” said Heather Smith, MD, an ob/gyn in Bronx, N.Y., who spoke on behalf of the American Congress of Obstetricians and Gynecologists. “This will impact care of our patients, especially those with ovarian cancer.”
The AMA House of Delegates passed a resolution Wednesday asking that CMS withdraw its proposal and, if that doesn’t happen, that the AMA lobby Congress block the proposal’s implementation. The proposal, if put into place, “would significantly undermine the ability of physician practices to meet the significant administrative and financial burdens associated with the rapidly evolving healthcare environment,” according to the resolution.
The CMS plan would replace the current Medicare reimbursement — the average sales price of the drug plus a 6% add-on fee to cover costs — with a rate of the average sales price plus 2.5%, plus a flat fee of $16.80 per drug per day. The flat fee would be adjusted at the beginning of each year.
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