Price, Shimkus, Boustany Respond to CMS’s Dismissal of Concerns Regarding the Proposed Medicare Part B Drug Payment Model

June 10, 2016 — Press Releases   

WASHINGTON, D.C. – House Ways and Means Committee Member and Budget Committee Chairman Tom Price, M.D. (R-GA), House Energy and Commerce Committee Member John Shimkus (R-IL), and House Ways and Means Committee Member Charles Boustany Jr, M.D. (R-LA) issued the following statements today upon receiving a letter from the Centers for Medicare & Medicaid Services (CMS) Acting Administrator Andy Slavitt in response to concerns raised about CMS’s proposed Medicare Part B Drug Payment Model:

“Do the Administration and CMS not understand, or do they just not care that millions of real patients’ lives will be adversely affected by the proposed Medicare Part B Drug Payment Model?” asked Congressman Price, M.D. “A total of 242 members of the House of Representatives, who represent millions of Americans, sent a letter to CMS voicing deep concerns about the real-life implications of the proposed Medicare Part B Drug Payment Model. Yet upon receiving the letter, CMS responded simply by saying little more than, ‘thank you for sharing your thoughts…and we appreciate your interest.’ CMS’s brief and uninformative response is dismissive of the risks posed to our nation’s sickest patients, including those with cancer, rheumatoid arthritis, rare diseases, and neurological disorders who could be adversely impacted by the proposal. Given CMS’s response, now more than ever, Congress must work to advance H.R. 5122—legislation which would stop the proposed Medicare Part B Payment Model in its tracks. We must continue to fight to protect access to essential drugs for those whose lives are at stake. Thus, we will charge onward despite this less than adequate response from CMS.”

“The lack of a substantive response from CMS to the detailed concerns raised by a bipartisan majority of the House of Representatives is not just disappointing, it’s disrespectful to the millions of individual patients and families we collectively represent,” said Congressman Shimkus. “What CMS is proposing under the guise of an ‘experiment’ is, in fact, a major policy change that threatens access to care for some of the most seriously ill Americans. Before this new payment model moves forward, the vulnerable seniors and elderly cancer patients whose health care options will be impacted by this change deserve a thoughtful response from CMS.” 

“As a doctor, I am dismayed by the arbitrary decision by CMS to slash reimbursement for in-office treatments like chemotherapy,” said Congressman Boustany, M.D. “This decision was made behind closed doors without the input of Congress, patients, or providers and demonstrates a dangerous lack of regard for access to critical drugs for seniors. CMS’s response to concerns raised by 242 Members of Congress was dismissive and disrespectful to the American people. We must continue the fight against these harmful healthcare policies and bring this ill-advised experiment to a halt.”

Background:
On March 8, 2016, CMS released a proposed rule modifying its reimbursement rate for Medicare Part B drugs. The new model is a mandatory demonstration project developed by the Center for Medicare & Medicaid Innovation (CMMI) that would be conducted across nearly all Primary Care Service Areas in the United States.

CMS’s proposed Medicare Part B Drug Payment Model creates disincentives for treating patients who depend on Medicare, including those with cancer, rheumatoid arthritis, rare diseases, and neurological disorders. In addition, it takes clinical decision-making out of the hands of physicians and patients.

On May 2, 2016, House Ways & Means Committee Member and Budget Committee Chairman Tom Price, M.D. (R-GA), House Energy & Commerce Committee Member John Shimkus (R-IL), and House Ways & Means Committee Member Charles Boustany Jr, M.D. (R-LA) spearheaded a letter — co-signed by 239 members of Congress — to CMS demanding that Acting Administrator Andy Slavitt withdraw the Administration’s proposed Medicare Part B Drug Payment Model.

In addition to spearheading this letter, Representatives Price, Boustany, and Shimkus are original co-sponsors of H.R. 5122 — legislation sponsored by Representatives Larry Buchson (R-IN) and Robert Dold (R-IL), which seeks to block the controversial new Medicare Part B Drug Payment Model.

SUBCOMMITTEE: Health