The “test program” would be a nationwide project, imposing major payment changes that would run for several years. It would, in effect, create an administratively imposed Medicare payment for an entire class of medical professionals, mostly physicians.
Beginning this year, the Center for Medicare and Medicaid Innovation (CMMI), an agency created by the Affordable Care Act (ACA), will change Medicare reimbursement for cancer drugs and certain other injectable therapies, mostly dispensed in doctors’ offices or in outpatient hospital settings.
While testing different payment systems and encouraging cost-effective drug therapies is obviously good policy, the radically broad use of demonstration authority in this instance amounts to executive overreach.
It will apply to all Medicare Part B providers and will cover almost all Medicare drugs and biologicals....