Hospitals do not prescribe more expensive drugs because they know the 340B program will help pay for them.

That is the conclusion drawn in a recent analysis by the Medicare Payment Advisory Commission.

Prescription drug spending has risen markedly in recent years and the pharmaceutical industry maintains that part of that increase can be attributed to hospitals that participate in the section 340B prescription drug discount program, which requires pharmaceutical companies to give discounts to hospitals and other selected providers that care for especially large numbers of low-income patients.

A new analysis by the Medicare Payment Advisory Commission, however, concludes that any such effect is minimal.

340B discounts are available for qualified patients receiving drugs on an outpatient basis, and the program’s greatest costs are associated with drugs to treat cancer.  MedPAC found that prescribing decisions “appears to be specific to the type of cancer” and concluded that “…we are unable to attribute these findings to incentives created by 340B discounts” and that “Overall effects on cost sharing for cancer patients is likely to be small, if any, depending on cancer and the patient’s supplemental coverage.”

MedPAC warns that the empirical evidence underlying its analysis was limited.

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Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues.

The issues on MedPAC’s January agenda were:

• The Medicare prescription drug program (Part D):  status report and options for restructuring
• Redesigning the Medicare Advantage quality program:  initial modeling of a value incentive program
• Hospital inpatient and outpatient payments
• Physician payments
• Outpatient dialysis payments
• Skilled nursing facility, home health, inpatient rehabilitation facility, and long-term-care hospital payments
• Hospice and ambulatory surgery center payments
• The 340B program
• ACO beneficiary assignment

MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program.  While its recommendations are not binding on either Congress or the administration, MedPAC is highly influential in governing circles and its recommendations often find their way into legislation, regulations, and new public policy.

Go here for links to the policy briefs and presentations that supported MedPAC’s discussion of these issues.…

Last week the Medicare Payment Advisory Commission met in Washington, D.C.  The Medicare payment issues on its agenda were:

• Assessing payment adequacy and updating payments: Physician and other health professional services
• Assessing payment adequacy and updating payments: Ambulatory surgical center services
• Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services;
• Mandated report: Expanding the post-acute care transfer policy to hospice
• Assessing payment adequacy and updating payments: Skilled nursing facility services
• Assessing payment adequacy and updating payments: Home health care services
• Assessing payment adequacy and updating payments: Inpatient rehabilitation facility services
• Assessing payment adequacy and updating payments: Long-term care hospital services
• Assessing payment adequacy and updating payments: Outpatient dialysis services
• Assessing payment adequacy and updating payments: Hospice services
• The Medicare Advantage program: Status report

A transcript of that MedPAC meeting is now available.  Find it here.…

Next month MedPAC will likely vote to recommend that ambulatory surgical centers receive no increase in their Medicare payments in 2021.

Meeting last week in Washington, D.C., members of the Medicare Payment Advisory Commission appeared to support strongly a staff recommendation to keep Medicare ambulatory surgical center payments where they are now – enough so to expedite resolution of the issue by voting on it at MedPAC’s next meeting, in mid-January.

MedPAC also will vote on a proposal to require ambulatory surgical centers to provide annual cost reports to the Centers for Medicare & Medicaid Services.  CMS would use those reports to evaluate facility revenue and profits so it can better assess the adequacy of Medicare rates.

Learn more in the Becker’s ASC Review article “ASC pay increase for 2021 eliminated in MedPAC’s draft proposal.”…

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues.

The issues on MedPAC’s December agenda were:

• Assessing payment adequacy and updating payments: Physician and other health professional services
• Assessing payment adequacy and updating payments: Ambulatory surgical center services
• Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services;
• Mandated report: Expanding the post-acute care transfer policy to hospice
• Assessing payment adequacy and updating payments: Skilled nursing facility services
• Assessing payment adequacy and updating payments: Home health care services
• Assessing payment adequacy and updating payments: Inpatient rehabilitation facility services
• Assessing payment adequacy and updating payments: Long-term care hospital services
• Assessing payment adequacy and updating payments: Outpatient dialysis services
• Assessing payment adequacy and updating payments: Hospice services
• The Medicare Advantage program: Status report

MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program.  While its recommendations are not binding on either Congress or the administration, MedPAC is highly influential in governing circles and its recommendations often find their way into legislation, regulations, and new public policy.

Go here for links to the policy briefs and presentations that supported MedPAC’s discussion of these issues.…