On September 10, 2018, AMCP submitted comments to CMS on its proposed revisions to the 2019 Physician Fee Schedule. While AMCP believes that a bundled episode of care payment is a step in the right direction to ensure patients with SUDs have access to care, AMCP provided CMS with several recommendations to consider when developing a formal proposal.
AMCP sends letter of concern for needed provisions in the Senate amendment in the nature of a substitute of H.R. 6 to Senate leadership and the Chairs and Ranking Members of HELP, Finance, Judiciary, and Commerce committees
On August 7, 2018, CMS issued guidance to Medicare Advantage (MA) plans acknowledging that step therapy is a recognized utilization management tool. CMS stated that the allowance of step therapy practices for Part B drugs will help achieve the goal of lower drug prices while maintaining access to covered services and drugs for beneficiaries. MA plans will have the choice of implementing step therapy to manage Part B drugs, beginning January 1, 2019.