COVID And Medicare: Pricing Restraints Needed For Part B Vaccines, MedPAC Panelists Say
GSK’s blockbuster Shingrix and other Part D vaccines would be switched to Part B under proposal being developed by influential advisory commission. Lack of pricing controls in Part B is generating concerns among panelists, though, as MedPAC aims to finalize its recommendations on revising Medicare reimbursement for vaccines by next spring.
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CMS will allow Part D vaccine administration to be billed and reimbursed separately from product costs in 2008, the agency states in guidance to Medicare drug plan sponsors issued May 14
Physician administration of Part D vaccines will be covered under Medicare Part B during 2007 and under Part D in 2008 and thereafter, under broad tax and health care legislation (HR 6111) signed into law by President George Bush Dec. 20
It’s not quite the rebate rule, but final reg aims for ‘a reduction in the use of rebates and other price concessions’ driven by the transparency requirement and broad definitions. PCMA warns that ‘mandating an increased level of disclosure for this information could result in higher prescription drug prices for consumers.’