Health Payer Intelligence February 6, 2020
Medicare Advantage proponents are concerned that the new CMS proposal may result in underpayment to Medicare Advantage plans for end-stage renal disease care.
While payers and Medicare Advantage proponents applauded elements of the Medicare Advantage rule that CMS proposed yesterday which will increase plans’ revenues by nearly one percent, many expressed concerns about the proposed rule’s approach to chronic disease management costs for patients with end-stage renal disease (ESRD).
The proposed rule mainly focuses on prescription drug pricing, giving Part D plans the ability to negotiate pricing, promoting less expensive generic and biosimilar drugs through a new “preferred” specialty tier, and allowing patients to compare drug prices for the one that best fits their needs and wallet.
But apart from...
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