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December 4, 2017

Alarming Medicare Part B Overhaul Plan Reduces Drug Choice, Access

  Institute for Policy Innovation

DALLAS - The Medicare Payment Advisory Commission (MedPAC), which provides Congress with advice on improving Medicare, is recommending a dramatic, deleterious overhaul to the Medicare Part B prescription drug program that would prioritize the government’s budgets over patients’ needs.

In a new publication, “Budgets First, Patients Last: MedPAC's Plan to Undermine Medicare Part B's Drug Benefit,” Institute for Policy Innovation (IPI) resident scholar Dr. Merrill Matthews says MedPAC’s proposed changes to Medicare Part B’s prescription drug reimbursement plan would put patients' lives at risk by reducing access to care, especially for the sickest and most vulnerable patients — a substantial segment of Medicare’s Part B drug program.

Medicare Part B, the program that pays for most physicians’ services, also covers prescription drugs administered by health care professionals in the physician’s office or in a hospital outpatient setting.

“MedPAC wants to change how Medicare Part B drugs are priced and reimbursed in an effort to push manufacturers, vendors and doctors into providing health care the way Washington thinks they should,” said Matthews. “The commission seeks to implement economic incentives that would encourage doctors to prescribe the oldest and cheapest technology—whether or not that is in the best interest of the patient.”

“If Part B drug reform is needed, MedPAC’s plan isn’t it,” said Matthews.

One of MedPAC’s convoluted proposals is its drug value program, which would use a “reference pricing” system, empowering bureaucrats to pick and choose which drugs they believe are the most effective for the price. MedPAC is very clear it wants to adopt a price control scheme similar to Parts A and B. 

Matthews warns the result of MedPAC’s proposals, if implemented, will surely be:

  • Fewer doctors participating in Part B drug administration;
  • Fewer opportunities for patients to access the newest and most advanced therapies; and
  • More patients receiving Part B drugs in the hospital rather than a physician's office, which drives up Part B spending—the very thing MedPAC’s proposals allegedly seek to counter. 

“The fundamental problem with MedPAC’s proposals is they are all variations of a price control scheme,” said Matthews. “MedPAC is following the path of all countries that spend significant amounts of taxpayer dollars on health care: looking for ways to reduce that spending. In short: budgets first, patients last.”

The Institute for Policy Innovation (IPI) is an independent, nonpartisan public policy organization based in Dallas. IPI resident scholar Dr. Merrill Matthews is available for interview by contacting Erin Humiston at (972) 874-5139, or erin@ipi.org. Copies of Budgets First, Patients Last: MedPAC's Plan to Undermine Medicare Part B's Drug Benefit are available at www.IPI.org. 

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