You learn something new every day. Recently, “the federal agency that runs Medicare said it would sharply lower what Medicare pays for certain drugs that certain hospitals buy and administer to patients through the subsidy program“. Initially, this seemed unfair to hospitals but then the article explained further:
- Hospitals eligible for the program buy drugs from pharmaceutical companies at a steep discount, and are currently reimbursed by Medicare at a rate that is 6% above what the average national sale price for that drug is. Hospitals keep the difference, which they use to finance operations or expand services to patients, the AHA has said.
- But critics of the program say the significant margin on the drugs incentivizes hospitals to overuse certain drugs or choose high-priced options. A Government Accountability Office report in 2015 found substantially higher drug spending per Medicare beneficiary at hospitals that received the subsidies.
- The White House said the new rule would lower drug spending next year by Medicare and its enrollees by $1.6 billion. It said Medicare beneficiaries would see about $320 million of those savings because the amounts they pay out of pocket for drugs are based on the amounts Medicare pays.
- The CMS said some hospitals would be exempt from the cuts in 2018, including children’s hospitals, some rural hospitals and some cancer hospitals.
Obviously, these hospitals had a sweet backroom deal and were raking it in. You would think they had some great soundbite why this program should continue. Well, here it is:
- The Chicago-based AHA, the Association of American Medical Colleges and America’s Essential Hospitals responded swiftly with a promise of legal action. The groups believe the Centers for Medicare and Medicaid Services, or CMS, “overstepped its statutory authority with this policy,” Bruce Siegel, president and chief executive of America’s Essential Hospitals, said in a statement.
- Hospital groups also plan to lobby Congress to halt the new rules, Tom Nickels, executive vice president of the AHA said, calling the new rule “ill-advised and unfortunate.”
Yeah, that was it. Overstepped authority. Ill-advised. Unfortunate. in other words….nothing. They just want the money. Welcome to our crony filled system.