Before following through with finalizing the changes to the Medicare Part B drug prescription program, CMS would benefit from addressing the many concerns sent forward during the comment period.

The proposed changes to the Medicare Part B prescription drug program is finding opposition among multiple medical organizations. The Centers for Medicare & Medicaid Services (CMS) will need to address the problems in the new proposed rule before continuing with finalizing these changes. The American Medical Group Association (AMGA) sent a letter to CMS stating its concerns with the renovations of the Medicare Part B prescription drug program.

According to a press release from AMGA, CMS should consider testing other options of the average sales price add-on payment as well as ensure that Medicare beneficiaries have full access to clinical decision data.

Additionally, physicians and other clinicians will need access to updated drug safety information as well as best practices guidelines. The AMGA also seeks for CMS to provide more details on exactly how hospitals and doctors will be evaluated on quality performance benchmarks.

The association is also stating that its members are looking to improve the quality and effectiveness of drug prescribing practices that benefit Medicare beneficiaries. These concerns will need to be addressed by CMS before any changes to the Medicare Part B prescription drug program are implemented by the agency.

Two months ago, CMS released the proposed rule that would affect reimbursement of providers operating through the Medicare Part B prescription drug program. New payment models would be used to help clinicians prescribe the right medication for their patients covered under Medicare. Positive Health outcomes would be tied into the reimbursement of providers once a medication is prescribed and utilized. CMS is also looking to reduce the spending associated with Medicare Part B since the costs of certain drugs have been rising in recent years, as the graph below illustrates.

See Graph at Health Payer Intelligence