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Medicare Part B, Breakthrough Drugs Get Reimbursement Boost In Senate COVID-19 Bill

 
• By Cathy Kelly

Legislation allows sponsors to request HCPCS code even before US FDA approval, but would extend the sequester until 2030 to pay for the temporary increase in payments for Part B drugs.

United States Capitol Building in Washington DC USA
Bill Aims To Enhance Medicare Payments To Bolster Care, Innovation

A new Senate bill responding to the COVID-19 crisis includes a number of Medicare-related provisions, including one that would suspend federal budget sequestration in Medicare for six months, effectively restoring payments to average sales price plus 6% for prescription drugs covered under Part B during that time.

The Coronavirus Aid, Relief and Economic Security (CARES) Act would boost Medicare Part B drug reimbursement from the current ASP...

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More from Medicare

Oz Says Big PBMs Have ‘Window’ to Quit Rebate System on Their Own

 
• By Leslie Small

CMS Administrator Mehmet Oz said PBMs may deserve "one last chance" to fix the rebate system before federal regulations and legislation are enacted.

Price Inflation Rebates: Biden Policies Add Teeth To Trump’s Pharma Tariff Threat

 
• By Cathy Kelly

Companies with significant exposure to Medicare and Medicaid have fewer options for passing along higher costs to consumers because of price controls in the programs.

PCMA, CVS, Cigna File Lawsuits Over ‘Dangerous’ Arkansas PBM Law

 
• By Tim Casey

The suits are an early test of the Arkansas law banning company ownership of PBMs and pharmacies in the state, as other states consider similar legislation.

Medicare Part D LIS Access Threatened By House Budget Bill’s Medicaid Obstacles

 
• By Cathy Kelly

An unintended consequence of a provision framed as an administrative change in the bill could significantly reduce medication adherence among low-income older adults and increase mortality, a study found.

More from Government Payers

Price Inflation Rebates: Biden Policies Add Teeth To Trump’s Pharma Tariff Threat

 
• By Cathy Kelly

Companies with significant exposure to Medicare and Medicaid have fewer options for passing along higher costs to consumers because of price controls in the programs.

Welireg Among Japan Recommendations; Economic Policy Raises Hopes Of Higher Prices

 
• By Lisa Takagi

Country recommends eights new drugs for approval, including six for rare diseases, and also announces macroeconomic policy the pharma industry says would enable some reimbursement prices to be raised.

HTA Expert Warns Of Escalating Measures If Pharma Fails To Tame Prices

 
• By Francesca Bruce

Too many “uninformative” drug trials fail to justify the excessively high prices of many medicines, while there is too much evidentiary uncertainty in European pricing and reimbursement systems, warned Anja Schiel from Norway’s NOMA.