Medicare Part B Drug "Least Costly Alternative" Policy Rescinded By CMS
Executive Summary
The Centers for Medicare and Medicaid Services has officially notified its contractors to stop using an option to limit payments for Medicare Part B drugs to the "least costly alternative" in a therapeutic class
You may also be interested in...
Reimbursement Briefs: Medicare Part B, PCORI Research
MedPAC will analyze alternatives for Medicare Part B to use “least costly alternative” payment method in lieu of legislative authority; OIG says Part B dispensing fees are too high; PCORI releases draft proposal on research review.
MedPAC Seeks Stakeholder Input On Medicare “Least Costly Alternative” Policy
Comments by members of the Medicare Payment Advisory Commission at a recent meeting suggest an opportunity for pharmaceutical industry stakeholders to help frame the discussion of Medicare value-based payment approaches for Part B drugs.
Lilly Says CMS Review Of Beta-Amyloid PET Goes Beyond Medicare Statutory Criteria
“Improvement in health outcomes” standard would interpret “the statute to require both diagnosis and treatment,” Lilly says about CMS’ recent evaluation of beta-amyloid positron emission tomography in dementia and neurodegenerative disease.