What We're Reading: Trump on Drug Pricing; MedPAC Looks at Fee Cut; Nursing Homes and MAT

President Donald Trump will deliver his first major speech on drug prices on April 26; a recent Medicare Payment Advisory Commission proposal would cut Medicare payment rates by 30% for some services at hospital-affiliated free-standing emergency departments; nursing homes routinely turn away patients seeking care if they are using medication-assisted treatment to treat substance use disorder for opioids.

Trump to Deliver First Speech on Drug Prices Next Week

President Donald Trump will deliver his first major speech about drug prices on April 26, Politico reported. Based on his fiscal 2019 budget request, he could advocate for Medicare and Medicaid demonstrations to test new ways of paying for drugs on a smaller scale, like allowing some states to try negotiating drug costs in Medicaid. He is unlikely to call for the sort of actions he did when he was a candidate, like allowing the government to negotiate the cost of drugs for Medicare.

MedPAC Proposes Cutting Rates to Stand Alone Emergency Departments

A recent Medicare Payment Advisory Commission (MedPAC) proposal would cut Medicare payment rates by 30% for some services at hospital-affiliated free-standing emergency departments (EDs) that are located within 6 miles of an on-campus hospital ED, Kaiser Health News reported. Free-standing EDs have been growing and now number more than 500. The proposal is spurred by concerns that MedPAC’s payment for services at these facilities is higher than it should be since the patients who visit them are sometimes not as severely injured or ill as those at hospital facilities.

Nursing Homes Unlawfully Rejecting Patients Using MAT for Opioid Use Disorder

Nursing homes routinely turn away patients seeking care if they are using medication-assisted treatment (MAT) to treat substance use disorder for opioids—a practice that legal experts say violates the Americans with Disabilities Act, STAT reported. After hospital discharge, many patients require further nursing care. But STAT has found that many nursing facilities refuse to accept such patients, often because of stigma, gaps in training, and the widespread misconception that abstinence is superior to medications for treating addiction. Nursing home staff may be unfamiliarity with MAT. Facilities may not have a clinician on staff licensed to prescribe buprenorphine and may be unaware that the patient’s primary care doctor often can continue to provide the medicine.