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MedPAC Recommends Conditioning Drug Pass-Through Status On Superiority

By John Wilkerson / April 2, 2021 at 12:23 PM
Congressional Medicare advisers voted Thursday (April 1) to recommend companies prove new drugs are better than existing treatments in order to be reimbursed separately from outpatient pay bundles. Drug costs are accounted for in Medicare hospital reimbursement for primary outpatient services. But some drugs are so expensive that pay bundles aren’t enough to cover their price, so Congress and CMS created ways to pay hospitals separately for these drugs and biologics. The problem is that paying outside of bundles makes...


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