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Some providers battle new Medicare drug-payment plan

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The Wall Street Journal reports that “Specialty physicians and other health-care providers have launched efforts to derail a federal proposal to test whether paying doctors less for drugs administered under a Medicare program reduces spending….”

“The administration says the proposal will help patients and won’t deny anyone access to drugs. But the reaction Wednesday suggested a major fight ahead, as specialty doctors, drug-industry groups and Republican lawmakers described the plan as ill-conceived.”

“Some cancer doctors want the proposal withdrawn because they fear independent practices will fold. Some said their reimbursements from the drugs barely cover their costs.”

“The bulk of the criticism targets a proposed reduction in how much providers are reimbursed under Medicare Part B, which includes drugs administered by doctors in offices and outpatient settings. Cancer centers and oncologists say curbing the rising pace of prescription-drug spending shouldn’t be handled by whittling away at their payments.”

“The Obama administration is in a tough spot. On one hand, Medicare Part B has been criticized for having perverse incentives—doctors get more money if they administer costlier drugs. Generally, under Part B, doctors are reimbursed the average sale price of a drug plus an additional 6% premium. Higher-priced drugs mean bigger profit.”






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