News and information useful to Cleveland-Marshall College of Law students, faculty and staff.

Archive for March 11th, 2016

CMS Seeking Comment on New Ways to Pay for Medicare Part B Drugs

CMS LogoPrescription drugs administered in a hospital outpatient department or physician’s office are covered by Medicare Part B. The U.S. Centers for Medicare & Medicaid Services (CMS) just released a proposed rule on a “Part B Drug Payment Model as a two-phase model that would test whether alternative drug payment designs will lead to a reduction in Medicare expenditures, while preserving or enhancing the quality of care proved to Medicare beneficiaries.” [See 81 Fed. Reg. 13230, 3/11/16.] The proposed model is envisioned to run for five years. The first phase would reduce, from 6% to 2.5%, the add-on to Average Sales Price (ASP) used to make Part B drug payments. “The second phase would implement value-based purchasing tools similar to those employed by commercial health plans, pharmacy benefit managers, hospitals, and other entities that manage health benefits and drug utilization.” The “value-based purchasing tools” to be tested include “reference pricing, indications-based pricing, outcomes-based risk-sharing agreements, and discounting or eliminating patient coinsurance amount.” After soliciting public comment on each proposal, each specific tool will be applied to specific Part B drugs. Thus, CMS seeks “to test approaches for transitioning from a volume-based payment system into one that encourages or even rewards providers and suppliers who maintain or achieve better patient outcomes while lowering Part B drug expenditures.” CMS is accepting comment on the proposed rule until 5/9/16. For additional information, see the 3/8/16 CMS media release Fact Sheet CMS proposes to test new Medicare Part B prescription drug models to improve quality of care and deliver better value for Medicare beneficiaries.

Next Week is Sunshine Week

Sun clip art

Did you know that March 13-19 is Sunshine Week? Celebrating its 11th year, Sunshine Week is a nationwide initiative to highlight the importance of freedom of information and government transparency. Sunshine Week was started by the American Society of News Editors in 2005, later joined by the Reporters Committee for Freedom of the Press, and includes participation by news media, government officials, academic institutions, libraries, and all people interested in open government. One of the main goals of Sunshine Week is to empower the public to get involved in all levels of government and to gain access to government information that can strengthen communities and individuals.

Why should a law student care about Sunshine Week? First, government information includes legal information. Think about administrative law and all of the regulations that impact people’s daily lives. Imagine if agencies could conduct their entire rule-making process in secret, instead of with the notice, comment, and review procedures in place today. Second, think about available internships and your future career plans. It is very likely that you may need to file FOIA requests and gain access to information about government agencies and officials. Finally, you are a member of the public, yes? You have a right to know what your government is doing and why, and a duty to be an informed citizen.

Want to learn more about Ohio’s Sunshine Laws, FOIA, and open government? Keep visiting our blog throughout the week!

Get ready for Sunshine Week by testing your First Amendment knowledge with this quiz.

Read different perspectives on Open Government with these Sunshine Week opinion pieces.

Highlighted events:

  • Monday! Speakers from the National Archive and the Office of Government Information Services will discuss the use of technology to further open government (live streaming available via YouTube), click here for more information.
  • Wednesday, March 16th and Thursday, March 17th the US Census Bureau is holding public workshops discussing the Bureau’s Open Government Plan, FOIA, Records Management, and more. The workshops are free, but registration is required to receive call-in information for participating off-site, click here for more details.