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

SAP Partners | <b>Community Oncology Alliance (COA)</b>

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.

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.