AMCP webinar that reviewed the major provisions contained in a recently released advanced notice of proposed rulemaking from CMS on the International Drug Pricing Index for Part B drugs and a recently proposed rule on the Medicare Advantage and Part D Program.
AMCP summarizes the final 2019 CMS Physician Fee Schedule. The final rule includes provisions relating to Substance Use-Disorder (SUD) prevention and includes an interim final rule that would allow telehealth service treatment for a SUD to be provided at the home of an individual for the first time starting in July, 2019.
On Nov 1, 2018 CMS issued a proposed rule that updates Medicare Advantage (MA) and Medicare Part D Programs. The proposed rule would allow MA plans to offer “additional telehealth benefits”, makes changes to dual-eligible special needs plans, would allow Part D plans to request standardized extracts of Medicare claims data about its plan enrollees, and proposes enhancements to star ratings.
On November 1, 2018, CMS finalized its rule for the 2019 Physician Fee Schedule (PFS) and the Quality Payment Program (QPP). In the final rule, CMS acknowledges responses to its comment solicitation in the proposed rule on creating a bundled episode of care for management and counseling treatment for substance use disorders. Additionally, CMS is implementing a provision from the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act through an interim final rule. The Final Rule also reduces wholesale acquisition cost (WAC)-based payment for newly-launched physician-administered drugs to 103% of WAC.