Part B Reimbursement Provisions Threaten Access to Care

The ACR has long held that Medicare should be able to negotiate with pharmaceutical companies and that patients’ out-of-pocket costs should be capped to make drugs more affordable.

However, the Build Back Better Act as passed by the House risks inadvertent cuts to Medicare reimbursements to providers who administer drugs covered by Medicare Part B and must purchase those treatments in advance from manufacturers. A recent study by Avalere found that providers could face a 40% hit to Part B reimbursements under the BBBA as passed by the House.

We continue to support Medicare
negotiation in both Part D and Part B but ask that the wording be revisited to
assure that reimbursement to physicians who have already purchased these
expensive treatments remain at a level where practices can afford to provide
them to their patients in a practice setting – a win for patients, access, and
Medicare.

 

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