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Drug pricing proposals raise red flags with specialists


 


“We request more clarity on any potential policies that would affect physician reimbursement,” the groups said. “Physicians have no control over the cost of drugs or ancillary services, nor over the severity of illness and comorbidities that drive the need for such services.”

The groups did support a few of the recommendations from the two documents, including requiring Medicare Part D plans to apply a substantial portion of the rebate at point of sale, establishing a Part D out-of-pocket maximum in the catastrophic phase to better protect beneficiaries against high drug costs, decreasing the consolidation by pharmacy benefit managers and others in the supply chain, and providing the Centers for Medicare & Medicaid Services with guidance on how drug-related value-based contracts and price reporting would affect other price regulations.

“We appreciate HHS’ continued focus on transparency and patient-centered care,” the groups said. “Knowing that HHS is committed to transforming the health care delivery system and the Medicare program by putting a strong focus on patient-centered care, so providers can direct their time and resources to patients and improving outcomes, is reassuring to our providers.”

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