US Reimbursement Briefs: Medicare Payments For New Drugs; 340B Rules; HHS' Best
Recent developments in US federal government regulation of prescription drug pricing and reimbursement.
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Centers for Medicare and Medicaid Services narrows the types of drugs eligible for add-on payments in the Medicare end-stage renal program as it tries to balance efforts to promote innovation with controlling costs.
Siding with coalition of hospitals, judge ruled that HHS lacked authority to cut Medicare reimbursement for drugs purchased at 340B prices. That should change the dynamics of the 340B reform debate heading into 2019 – but don’t expect the Trump Administration to back down on its push to rein in what it sees as abuses of the discount.
Medicare’s current approach to inpatient CAR-T reimbursement in 2019 would lead to an $186,500 shortfall for providers per patient, stakeholders estimate.