Dive Brief:
- CMS Deputy Administrator Patrick Conway suggested Tuesday at a Senate Finance Committee hearing that the administration may consider adjustments to its controversial Medicare drug pricing proposal, The Hill reported.
- The comment came in response to heavy criticism of the rule that included opposition from every Republican on the committee and withheld support from Democrats pending requested changes.
- The proposal would change how Medicare Part B reimburses providers for drugs administered by hospitals and physicians’ offices in an effort to combat high drug costs.
Dive Insight:
The proposal has raised concerns among both Republicans and Democrats, with one of the chief issues being whether it would hinder patients' access to drugs.
"We are reviewing the comments now and plan to make adjustments in the final rule,” Conway said.
The rule would change drug reimbursement from the average price plus 6% to the average price plus 2.5% and a flat fee of about $16, in an effort to remove the incentive to prescribe higher-cost medications.
Many of the prescriptions that would be impacted would be for oncology drugs due to their rapid development and cost increases, Morning Consult noted.
The worry is that if Medicare reimbursement is too low to cover physicians' costs for some drugs, patient access will be harmed, particularly for those accessing rural or small practices.
Conway said the administration would consider whether adjustments are needed for rural or small practices, or whether the the rule should be scaled back so it doesn't apply to the entire U.S.