Becker's Healthcare September 25, 2024
Physicians could lose at least $25 billion in add-on payments for Part B drugs that could be part of the Inflation Reduction Act’s program to negotiate drugs, according to a recent study by Avalere.
The study, funded by the Community Oncology Alliance, analyzes changes to reimbursements based on the IRA’s Medicare Drug Negotiation Program. In August, CMS released the prices for the first 10 drugs that have been negotiated for Medicare Part D; they will go into effect Jan. 1, 2026.
Currently, Medicare reimburses physician-administered Part B drugs at the average sales price plus a 6% add-on payment, which is adjusted down to 4.3% by sequestration. Because of the way the IRA is operationalized, the add-on payment will now...
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