Medicare Payment Demo Would Put Often-Prescribed Cancer Drugs ‘Underwater’

Community oncology practices and hospitals strongly object to CMS’ plan for testing different reimbursement formula Part B drugs, which is expected to particularly impact treatments for cancer, arthritis and eye disease.

Nearly 50 of the most frequently-prescribed oncology or treatment-related drugs would be ‘underwater’ – or reimbursed at less than acquisition cost – under the payment rate in the Medicare demonstration project recently proposed by the Centers for Medicare and Medicaid Services, according to the Community Oncology Alliance.

In May 9 comments to CMS, the oncology provider organization takes issue with the agency’s claim that the proposed payment...

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