COA Releases Statement on CMS' Proposed Rules for 2019 Medicare Physician Fee Schedule

Following CMS’ announcement of proposed rules for the 2019 Medicare Physician Fee Schedule, Community Oncology Alliance (COA) released a statement calling the proposals “puzzling.” The statement details concern with 2 proposals.

The first is CMS’ proposal to cut payment for the evaluation and management of more complex cancer cases from $172 to $135 for a new patent and from $148 to $93 for an existing patient. According to COA, the proposal undervalues the evaluation and management of seniors with cancer, especially life-threatening, complex cases.

The second highlighted proposal is cutting Medicare Part B reimbursement for new cancer drugs and other specialty therapies to the rate of list price plus 1.35%—down from wholesale acquisition cost plus 6%—for the first 6 months on the market. COA believes that the payment cut for new cancer drugs will result in drug manufacturers increasing WAC list prices.

Read the full press release here.