A bill to block a controversial Medicare payment experiment would increase government spending by $395 million over the next decade, a nonpartisan agency found.
The bill would prevent the Obama administration from implementing a proposal to modify payments made to doctors for prescription drugs covered in Medicare Part B. Doctors currently get paid by the federal government the average sales price of the drug and a 6 percent add-on, while the proposal would change that to 2.5 percent plus a flat fee of $16.80 per drug per day.
The Congressional Budget Office reviewed the legislation, which would prevent the Department of Health and Human Services from implementing the proposed experiment.
The agency found that enacting the bill would increase direct spending by $395 million from 2017 to 2026.
“That estimate includes the savings that would be lost if the proposed demonstration was blocked, offset in part by additional savings that would result from [the Center for Medicare and Medicaid Innovation’s] ability to mitigate that loss by replacing the blocked demonstration with other projects, some of which would reduce federal spending,” the budget office said.
The model has generated a large amount of controversy since it was proposed by the Centers for Medicare and Medicaid Services in March.
Republicans introduced the House bill to block it, saying that the proposal lacked oversight and would result in a reduction in patient choice. Some lawmakers have said the project could hurt smaller doctors’ offices in rural areas.
But CMS counters that the demonstration would help steer doctors toward providing drugs that offer more value. It would deter doctors from prescribing higher-priced prescription products to patients that cost more and in turn would give them more money via the 6 percent fee.
Medicare Part B covers expenses such as doctor visits and drugs that are administered in a doctor’s office, which the demonstration project targets. Some examples of Part B drugs include cancer drugs.
