Medicare Value-Based Contracting, Vendor Price Negotiation To Be Tested In Part B Demo
CMS using authority from previously abandoned competitive acquisition program; vendors may get ability to use formularies and apply utilization management techniques like prior authorization and step therapy.
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Whether an opening gambit for negotiation or the most industry is willing to concede, proposals being offered by industry to replace the Trump Administration’s plan to pursue international reference pricing for Part B drugs seem modest.
Approach offered as alternative to more disruptive changes to Part B's existing buy-and-bill system; more aggressive proposals include new iteration of competitive acquisition program and moving Part B drug coverage to Part D.
Two highly anticipated proposed rules in Medicare Part D are scheduled for near-term release.