This week, Chairman Coelho sent a letter to the Medicare Payment Advisory Commission (MedPAC) in response to a recent session. In September's public meeting, the Commission discussed developing payment policy based on the use of clinical evidence, with specific focus on reinstating the least costly alternative (LCA) policy to Medicare Part B drugs and biologicals.
PIPC is deeply concerned with the Commission’s support for this proposal, which would allow for cost-based determinations of patient treatment options. PIPC fought hard for patient protections in the Affordable Care Act that ensure CMS does not misuse clinical CER to impose “one-size-fits-all” coverage or payment policies. LCA would undercut these protections and prevent doctors and patients from making informed decisions about the treatment option that is best for the individual patient. Therefore, we urge MedPAC not to move forward in recommending new LCA authority for CMS.
| pipc_ltr_to_medpac_re_lca_final.pdf |
