Tell Congress to Protect Medicare Part B
Urge Congress to stand with our most vulnerable citizens by protecting the Medicare Part B reimbursement framework. The Centers for Medicare and Medicare Services have proposed to overhaul the way providers are reimbursed through this essential program. Changes to Part B would disrupt patient access to critical treatments and endanger the financial stability of community practices and clinics.
Send the sample letter below to your Representative or Senator.
The Medicare Part B program provides insurance benefits for seniors who require prescription medications that must be administered by a medical professional. These therapies treat complex, chronic diseases including cancers, rheumatoid arthritis, and multiple sclerosis, among many other illnesses that disproportionally affect older populations.
The Centers for Medicare and Medicaid (CMS) has proposed a completely new framework for covering these specialty treatments, called the Proposed Medicare Part B Payment Model, in an attempt to cut costs and keep the Medicare system sustainable. However, the Proposed Model threatens patients' access to the treatments they need by reducing the ability of providers, especially those in rural and community-based care settings, to acquire medicines covered under the program. Providers have to pay for these expensive medications up front, and are only reimbursed for the Average Sales Price (ASP) for a particular drug, plus a small percentage of the ASP as compensation. The large portion of provider groups who pay more than the ASP for the medicine count on the additional percentage of compensation to cover the full cost of the drug.
Under this proposed change, patients who require a drug therapy that costs more than the average reimbursement rate may have trouble acquiring the therapy in a timely manner or may be effectively unable to do so. This could particularly affect patients who rely on rural or community-based provider groups, which may lack the resources to absorb financial losses under the Proposed Model. If these patients are unable to receive treatment from their primary care practitioners, they could be forced to travel much farther to large, expensive hospitals for care, or worse, forgo treatment altogether.
Disrupting or delaying patient access to regular treatment for chronic conditions not only negatively impacts patients' quality of life in the short-term, but can threaten their health outcomes over the longer-term. Nonadherence to prescription drug regimens can lead to more expensive complications, potentially resulting in hospitalizations, surgical interventions, or intensive supportive care. I urge you to act to ensure that the Proposed Payment Model is withdrawn before it can get between patients and the medicines they need.
Medicare represents a promise made to Americans that they will have access to quality affordable health care as they age or if they become disabled. The Partnership to Protect Medicare formed in 2011 to make sure that promise is kept for those Medicare beneficiaries who rely on life changing treatments and cures delivered through Medicare Part B.
Supported by patient advocacy organizations, medical providers and leaders in the health care industry, our mission is to fight experimental changes that will reduce, and in some cases eliminate, access to critical care for some of Medicare's most vulnerable patients. Through a variety of advocacy efforts, we seek to call attention to the impact of modifications to Medicare Part B on beneficiaries and to ensure that the government does not implement changes that could hurt Medicare recipients.