Medicare Advisers Say ‘Donut Hole’ Changes To Part D Program Could Lead To Spike In Costs For Everyone But Insurers
MedPAC said that the way Congress made changes to the Medicare Part D program disincentivizes insurers from trying to manage high drug costs because it puts pharma on the hook for a higher percentage of the drugs. In other news, MedPAC advisers are also expected to call on Congress to boost payments to hospitals, and Medicaid advisers will urge lawmakers to rethink cuts to hospitals.
MedPAC Criticizes Congress For ‘Donut Hole’ Changes
Congress’ Medicare advisers are chiding lawmakers for a controversial change they made to the Medicare prescription drug program’s so-called donut hole last year. The group, known as MedPAC, argued in its annual report Friday that the change — which puts drug makers, rather than insurers, on the hook for a higher percentage of the cost of some Medicare drugs — disincentivizes insurance companies from managing high drug costs. (Florko, 3/15)
MedPAC Wants To Boost Medicare Acute-Care Hospital Payments 2.8%
Medicare payment advisors are expected to call on Congress to boost payments to hospitals by 2.8%, with some of the raise going to fund a revamped quality program. The Medicare Payment Advisory Commission made the recommendation in its March report to Congress expected to be released on Friday, the executive director of the commission said. It is rare for MedPAC to call for a payment above current law, but the panel was concerned that high-quality hospitals were losing money under Medicare. (King, 3/15)
MACPAC Urges Congress To Retool Medicaid DSH Cuts
Federal Medicaid advisors in their extensive annual report urged Congress to rethink Medicaid disproportionate share hospital cuts to nudge the money toward hospitals that need it most. The Medicaid and CHIP Payment and Access Commission (MACPAC) recommended that this serve as a step for lawmakers to recalibrate the DSH allotments which now "have little meaningful relationship to measures meant to identify those hospitals most in need." (Luthi, 3/15)