DHPA

  • Home
  • About Us
    • Leadership
      • Executive Committee
      • Board Members
    • DHPA Members
    • Contact Us
    • Join Us
  • Advocacy
    • Patient Access to Independent GI Care
      • Colorectal Cancer Screening
    • Modernizing the Stark Law
    • Saving the IOASE
    • Pathology Services Utilization
  • Resources
    • Research
    • Fact Sheets
    • Letters to Policymakers
  • Newsroom
    • Press Releases
    • DHPA in the News
    • GI News Round Up
  • Take Action
    • Past Actions

March 17, 2016

DHPA to Congressional Leadership: Ask CMS to Withdraw Proposed Medicare Part B Drug Payment Model

The Digestive Health Physicians Association (DHPA) has joined a coalition of more than 300 leading patient, disease and provider organizations in sending a letter to congressional leadership requesting that they ask the Centers for Medicare & Medicaid Services (CMS) to permanently withdraw its proposed rule that would implement a new “Medicare Part B Payment Model.”

On March 8th, CMS announced a proposed rule designed to implement a new two-phase “Medicare Part B Payment Model.” The proposal seeks to test alternative drug payment designs in an effort to reduce spending. Specifically, the first phase of the proposal, beginning in late 2016, would reduce Part B drug reimbursement from the ASP+6 percent model to ASP+2.5 percent with an additional add-on payment of $16.80 per drug/per day. Then in 2017, CMS intends to begin testing new value-based purchasing options. There is a 60 day comment period for this proposed rule, ending on May 9th. DHPA intends to submit formal comments to CMS on this proposal.

The letter to congressional leadership brought to light the fact that an initiative focused on costs rather than patients and healthcare quality, and implemented based on primary care service areas rather than the unique challenges facing patients, is misguided and ill-considered. It also pointed out that data show the current Part B drug payment system has been cost effective and successful in ensuring patient access to their most appropriate treatment, as expenditures have remained relatively stable and Part B drugs account for just 3 percent of total program costs.

The coalition further expressed concern that CMS did not receive sufficient stakeholder input and that implementation of the new model will, “adversely affect the care and treatment of Medicare patients with complex conditions, such as cancer, macular degeneration, hypertension, rheumatoid arthritis, Crohn’s disease and ulcerative colitis, and primary immunodeficiency diseases.”

Medicare beneficiaries, some of the nation’s oldest and sickest patients, must often try multiple medications before finding the appropriate treatment for complex conditions. Requiring patients and the providers who care for them to participate in this initiative may force them to switch from the most appropriate medication – further complicating already complex care and treatment options.

At DHPA’s request, the coalition agreed to include Crohn’s disease and ulcerative colitis to the list of conditions that will be adversely impacted by this proposed rule. Within the coalition, GI physicians and patients they care for were represented by numerous state-based associations, two national organizations, DHPA and the American Gastroenterological Association (AGA), as well as a number of disease specific advocacy organizations, including the Colon Cancer Alliance, the Global Colon Cancer Association and others.

Click here to read the full letter to congressional leadership.

Filed Under: Advocacy, Letters to Policymakers, Newsroom, Protecting Patient Access to Integrated GI Care in the Independent Setting

Member Spotlight

Since opening in 2004, East Valley Gastroenterology & Hepatology Associates has helped tens of thousands of people with digestive and liver disorders. They are dedicated to the future of digestive healthcare and actively participate in clinical research trials.

 

Learn more at:
www.eastvalleygastro.com

Become a Member

    Is your practice interested in promoting and preserving accessible, high quality and cost-efficient care in the independent GI medical setting? Contact us today about joining DHPA.

    Recent News

    • GI News Round Up – Friday December 18

    • DHPA Opposes Most Favored Nation Rule Announced by CMS

    • DHPA Supports USPSTF Recommendations to Begin CRC Screening at 45, Calls for More Research on Disparities in Communities of Color

    • Broad Physician Coalition Urges Trump Administration to Issue Final Rules to Modernize Stark

    • Physicians, Patients Give Telehealth High Marks During COVID-19 Pandemic

    • USA Today: Telehealth can be lifesaving amid COVID-19, yet as virus rages, insurance companies look to scale back

    • Healio Gastroenterology: Telehealth in a Pandemic, Just the Beginning of the Story

    • Ending Social Injustice and Health Care Disparities

    • Medscape: Gastroenterology Groups Map a Return to Elective Endoscopy

    Digestive Health Physicians Association, Inc.
    10770 Columbia Pike, Suite 400
    Silver Spring, Maryland, 20901
    © 2020 DHPA

    Follow @DHPAnews
    Tweets by DHPAnews

    Copyright © 2021 · Executive Pro Theme on Genesis Framework · WordPress · Log in