CMS Bound To Current Approach To Sequester Cuts For Part B Drugs, Agency Says
This article was originally published in The Pink Sheet Daily
CMS says it must follow its current approach to Part B drug payment cuts, but oncology provider groups maintain the administration does have discretion to exempt at least part of the ASP plus 6% payment from the required 2% reduction under the sequester.
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A 2% cut is being applied first to the average sales price for drugs reimbursed by Medicare Part B, and then another 2% is taken out of the 6% add-on. The approach compounds the overall reduction to a level that far exceeds the 2% Medicare cut required by sequestration, according to the groups.
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Former CMS acting administrator Andy Slavitt says agency’s direction during Biden administration depends on nominee, but trust fund’s looming insolvency will be ‘an issue you can’t avoid.’ The president’s priorities around health equity, racial justice and mental health will make their way into CMS policy and demonstration models, Slavitt suggests.