Medicare Drug Pricing Reform to Be 'Adjusted'

A controversial Medicare drug-pricing pilot program is being "adjusted" after heavy criticism from both sides of the aisle, The Hill reported Tuesday, citing an announcement from an Obama administration health care official. 

"We are reviewing the comments now and plan to make adjustments in the final rule" regarding implementation of the new program, the Centers for Medicare and Medicaid Services official, Dr. Patrick Conway, told the Senate Finance Committee.

As recommended by the Medicare Payment Advisory Commission, an independent congressional agency, the proposal aims to reduce rising drug prices by altering how Medicare Part B pays for them.

Currently, doctors and hospitals get paid the average drug price plus 6 percent by Medicare for medications given in their facilities, giving them an incentive to prescribe more expensive drugs. The proposal would lower the additional payment from 6 percent to 2.5 percent, and would add a roughly $16 flat fee, according to Morning Consult. 

Republicans oppose the plan completely, while Democrats are calling for adjustments before the program goes forward, according to The Hill. Democratic Sens. Ron Wyden of Oregon and Debbie Stabenow of Michigan raised two objections. One, that drug costs for small or rural practices could become too exorbitant for doctors to afford without the higher Medicare reimbursement, which could affect patient access to medication. And two, that the program "seems broader than is typical of a demonstration project," according to Stabenow.

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