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WASHINGTON The Centers for Medicare & Medicaid Services (CMS) should reduce its portfolio of alternative payment models, according to a draft recommendation released by the Medicare Payment Advisory Commission (MedPAC). I think there s merit in streamlining the models, commission member Brian DeBusk, PhD, CEO of DeRoyal Industries in Powell, Tennessee, said Thursday at MedPAC s March meeting. Medicare might welcome the relief; I m sure they get pressed from a lot of different sides to pursue a lot of different programs.
DeBusk was responding to a draft recommendation written by MedPAC staff for possible inclusion in the commission s annual June report to Congress. The draft recommendation said that The [Health and Human Services] Secretary should implement a more coordinated portfolio of fewer alternative payment models (APMs) that support the strategic objectives of reducing spending and improving quality.
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Dive Brief:
Members of an influential congressional advisory committee on Medicare are torn on how best to regulate telehealth after the COVID-19 public health emergency, hinting at the difficulty Washington faces as it looks to impose guardrails on virtual care without restricting its use after the pandemic ends.
During a Thursday virtual meeting, the Medicare Payment Advisory Commission expressed its support of telehealth broadly, but many members noted snowballing use of the new modality could create more fraud and abuse in the system down the line.
Key questions of how much Medicare reimburses for telehealth visits and what type of visits are paid for won t be easily answered, MedPAC commissioners noted. This is a really, really difficult nut to crack, Michael Chernew, MedPAC chairman and a healthcare policy professor at Harvard Medical School, said.
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WASHINGTON The fate of the Trump administration s most favored nation (MFN) rule for bringing down prescription drug prices remains uncertain as President-elect Joe Biden prepares to assume office later this month.
On Sept. 13, 2020, President Trump signed an executive order saying that the Department of Health and Human Services would test payment models for Medicare Parts B and D in which Medicare would pay for certain drugs not more than the most favored nation price, defined as the lowest price, after adjusting for volume and differences in national gross domestic product, for a pharmaceutical product that the drug manufacturer sells in a member country of the Organisation for Economic Co-operation and Development that has a comparable per-capita gross domestic product.