McCarter & English, LLP’s Health Care Group presents Issue 8 of the Health Law Insights, which discusses the latest legal issues in the health care industry.
NATIONAL -
New Payment Model for Part B Drugs Proposed -
The Centers for Medicare and Medicaid Services published on March 11 a proposed rule (81 Fed. Reg.13230) to experiment with an alternative payment model for Medicare Part B prescription drugs. Currently, physicians and hospitals receive a Part B drug reimbursement in the amount of the average sales price, plus 6%. The proposed payment model would reduce the add-on payment to 2.5% and pay a flat fee of $16.80 per drug per day. CMS would update the flat fee at the beginning of each year by the percentage increase in the consumer price index for medical care for the most recent 12-month period.
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