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Medicare Part B Changes: Good or Bad?

Changes to Medicare this fall have both sides speaking out about how it will affect recipients.(Virginia Carter)
Changes to Medicare this fall have both sides speaking out about how it will affect recipients.
(Virginia Carter)
October 21, 2016

ANNAPOLIS, Md. – Medicare plans to roll out changes to the Part B program designed to lower the cost of chemotherapy by cutting drug payments and encouraging physicians to use cheaper alternatives. It's called the Medicare Part B Drug Demo.

Dr. Blase Polite, chairman of the American Society Clinical Oncology, Government Relations Committee, and Assistant Professor of Medicine at the University of Chicago, said it's a bad idea because some patients don't have alternatives, they need a specific drug at a specific time for their cancer. Because of that, he said Medicare actually would be trimming coverage, and hurting doctors and their patients by cutting reimbursement costs.

"Not just the cancer doctors, but the eye doctors for people who have macular degeneration, the people with, you know, bowel disease going to the gastroenterologist, the rheumatologist, people with rheumatoid arthritis, all those folks are going to lose out under this thing," he explained.

The plan has gotten support from the Medicare Rights Center and AARP, which say taxpayers and Medicare recipients can't continue to pay for overpriced prescription drugs. AARP said last year Medicare Part B spent $22 billion on prescription drugs, double the amount spent in 2007.

Erin Parrish, director of Advocacy and Outreach at A.A.R.P Minnesota, said the changes center around what's better for the patients so the drugs they receive are focused on how well they work, not the price tag.

"The current Part B payment method provides weak incentives for physicians to consider value, that is, choose the lowest-cost therapy to effectively treat a patient," she said. "This proposed demo appropriately focuses on changing prescriber behavior and does not unfairly penalize beneficiaries."

Currently, Medicare Part B pays providers based on a drug's average sales price plus an additional six percent. The proposal will change it to 2.5 percent, plus a flat fee. Advocates call it a thoughtful, measured approach to modernizing the way Medicare pays for expensive drugs, Polite said it will hurt doctors with small offices the most. He said Congress can refuse to let the changes take place.

Veronica Carter, Public News Service - MD