The Medicare Payment Advisory Commission has finalized recommendations for Congress aimed at reducing growth in Part B drug spending.
Here are four things to know about MedPAC's proposals.
1. The commission recommended modifying the reimbursement for Part B drugs that are paid for based on wholesale acquisition cost — a manufacturer's undiscounted price to wholesalers or direct purchasers. Under the proposals, the payment rate for WAC-priced drugs would be reduced to WAC plus 3 percent, down from the current rate of WAC plus 6 percent.
2. MedPAC recommended requiring all Part B drug manufacturers to submit annual average sales price data. Currently, only Medicare Part B drug manufacturers with Medicaid drug rebate agreements are required to submit annual average sales price data.
3. For drugs that are paid for based on average sales price, physicians and hospital outpatient departments are typically paid the ASP of a drug, plus a 6 percent add-on. The proposals would require manufacturers to pay Medicare a rebate with the ASP for their product if it exceeds an inflation benchmark such as the consumer price index.
4. The commission recommended creating a voluntary Drug Value Program that would be phased in by 2022. Under the program, private vendors would negotiate lower Part B drug prices.
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