Part B Demo Could Save $2.2 Bil., CBO Says; Blocking It Would Cost Less

CMS’ proposal to test alternate payment methods for Part B drugs could save as much as $2.2 billion over 10 years, the Congressional Budget Office told Congress. However, a bill to block implementation of the program would only cost $395 million for scoring purposes.

Syringes stuck in a dartboard

The proposed Center for Medicare & Medicaid Services (CMS) demonstration project to test alternative payment models for Part B drugs would save about 1% of the total amount spent on Medicare Part B if it were implemented as proposed, the Congressional Budget Office (CBO) indicates in an analysis released Oct. 4.

In a draft rule issued in March, CMS proposed testing alternatives to the statutory payment formula of ASP+6%. As proposed, CMS would start by paying half of Part B providers at ASP+2.5% plus a flat fee of $16.80. A second phase of the demo would then apply value-based pricing as an alternative to the ASP-based formulas

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