CMS announced yesterday, March 8th, that they would be testing new payment models for prescription drugs covered by Medicare Part B. Prescription drugs covered by Medicare Part B typically fall into one of the three categories below:
- Drugs given through physician service in office or outpatient hospital settings
- Drugs given through a covered item of durable medical equipment
- Other categories outlined specifically by law
The CMS explains in their Illustrative Example that the current model could discourage doctors from administering lower cost drug alternatives that could actually be more effective. Testing of the new models also outlined in the example could encourage physicians to treat patients with the most effective drug combined with the best value.
See Also: CMS Opioid Monitoring System Successful in Part D Recipients