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CMS Should 'Clarify' Part B Inflation Rebates Don't Apply In Medicare Advantage, Pharma Says

 
• By Cathy Kelly

Manufacturers ‘strongly object’ to the possibility floated by the Centers for Medicare and Medicaid Services that it could extend price inflation rebates to Part B drugs furnished to enrollees in Medicare Advantage plans in addition to those covered by fee-for-service Medicare.

CMS could apply price inflation rebates more broadly for Part B drugs. • Source: Shutterstock

The US Centers for Medicare and Medicaid Services has no legal basis to move ahead with a policy that would add drugs covered by Medicare Advantage plans to the calculation of price inflation rebates in Medicare Part B, according to pharmaceutical manufacturers.

Key Takeaways

  • The pharma industry strongly opposes CMS’ suggestion that it may in the future impose price inflation rebates on drugs covered by Medicare Advantage plans in addition to those covered by traditional Medicare.

“CMS does not have authority to include units of Part B rebatable drugs furnished to MA enrollees in the calculation...

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