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CMS Payment Experiment Strains Legal Powers, Reimbursement Norms

 
• By Cathy Kelly

'Perverse' new payment model for Part B drugs may test the limits of its innovation center’s waiver authority and has already drawn lawsuit threat.

The Medicare Part B payment model being planned by the Centers for Medicare and Medicaid Services has drawn threats of legal and congressional action even in its current state as a proposed rule, demonstrating the strength of the opposition against it.

Announced by the agency March 8, the payment model for Part B drugs is envisioned as a large-scale initiative that would rework average sales price-based payments to providers for the majority of Part B drugs in an effort

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More from United States

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Will International Prices Influence Medicare Price Negotiation?

 
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A former CMS official suggested the most likely way it could happen is through a Center for Medicare and Medicaid Innovation demonstration.

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FDA Use Of Artificial Intelligence Will Help US Retain Biotech Leadership

 
• By Sue Sutter and Derrick Gingery

At a House subcommittee hearing, HHS Secretary Robert F. Kennedy Jr. rebutted lawmaker concerns that NIH cuts will drive research and scientists to other countries and said he does not want to advise parents on vaccinating children for measles, chickenpox or polio.

More from North America

HHS Secretary Kennedy Says Trump Will Make Final Decision On Mifepristone Policy

 
• By Derrick Gingery

With an FDA review ongoing, Kennedy’s admission, made during a Senate hearing on the Health and Human Services Department’s budget request, suggests political officials could supersede scientific decisions.

Industry Leaders Grapple With Trump’s Most Favored Nation Pricing Plan

 
• By Jessica Merrill

At the Bank of America health care conference, pharma leaders speculated on the impact of Trump’s most favored nation pricing executive order on US and European markets.

Most Favored Nation Policy ‘Lazy, Misguided,’ But US Price Reforms Politically ‘Inevitable’

 
• By Cathy Kelly

Policy experts and pharma executives react to President Trump’s executive order on “equalizing” drug prices between the US and comparable nations at the ISPOR 2025 conference.