CMS Abandons Pilot for Outcomes-Based Payment Model of Part B Drugs

The Centers for Medicare and Medicaid Services will not proceed with finalizing a proposed rule that would have lowered add-on payments to physicians and introduced a value-based purchasing tool for Medicare Part B drugs.

The proposal received significant opposition from the pharmaceutical industry, prompting CMS to abandon implementing the measure in the final days of the Obama administration. “The complexity of the issues and the limited time available led to the decision not to finalize the rule,” CMS said.

The proposed program would have decreased the add-on payment physicians receive for the average cost of a Part B drug to 2.5 percent, with a daily flat payment of $16.80. Currently, physicians receive an add-on payment of 6 percent. The measure would have also based Medicare reimbursements on the effectiveness of a drug.