Medicare Walks Back Proposed Payment Policy For 505(b)(2) Physician Administered Drugs
CMS acknowledges stakeholders may need more details about the plan before it is finalized and a delay will give the agency more time to ‘consider the issue.’
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Medicare Part B payment loopholes also targeted in law, and Medicare Part D plans will need to offer real-time benefit tools for prescriber-patient decision making.
BMS, Biogen and other urge CMS to rescind its proposal to reimburse Part B drugs approved under section 505(b)(2) as multiple source products. The proposal would target one relatively small but growing part of Medicare Rx spending and reflects CMS’ ongoing concern with fast rising costs in the program
If not reversed by the Biden Administration, demo program that puts plans at increased risk in catastrophic phase would also enhance negotiating leverage for drugs in the protected classes.