Including Oral-Only ESRD Drugs In Payment Bundle Could Harm Access: GAO
The inclusion of oral-only end-stage renal disease drugs in the Medicare prospective payment system beginning in 2014 could have a negative effect on access to these drugs if facilities consider bundled reimbursement to be inadequate to cover their cost, according to an analysis by the Government Accountability Office.
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Rep. Peter Welch introduces a bill that would overturn a provision in the American Taxpayer Relief Act delaying the bundling of oral-only drugs for ESRD treatment, such as Amgen’s Sensipar, until 2016.
In legislation passed by both chambers of Congress Jan. 1, the cost of a one-year reprieve from sharp cuts to Medicare physician payments, scheduled to begin in 2013, would be offset by a reduction in Medicare’s bundled payment for end-stage renal disease. The reduced payment would take into account a drop in the use of erythropoiesis-stimulating agents observed over the last several years.