CMS Proposes Most Favored Nation Rule Withdrawal

LUGPA is pleased to announce that on Friday August 6,CMS issued a Proposed Rule which rescinds the Most Favored Nation Model Interim Final Rule on Part B Drug Pricing (MFN IFR).  That rule, if implemented, would have replaced payment models for essential medications with a flat fee that, in many cases, would have been insufficient to cover the acquisition and administration costs of these drugs. This would have placed an enormous economic burden on both providers and patients, which would have potentially compromised access to care to life-saving medications—indeed, CMS’ own accounting indicated that over 25% of savings accrued by this proposal would be the result of beneficiaries simply not getting medications.

LUGPA’s Health Policy and Political Affairs apparatus was fully engaged in opposition to the MFN IFR, which circumvented the normal notice, comment period, and rulemaking process, and strongly advocated for its withdrawal. In particular, LUGPA engaged closely with stakeholders who filed suit to prevent implementation of the MFN IFR—this litigation resulted in  a federal court issuing a preliminary injunction preventing CMS from implementing the rule in December. This injunctive relief was scheduled to expire August 9; the recission of the rule on Friday can be directly attributed to this deadline.

This success underscores the need for continued vigilance with respect to Part B drugs.  At present, there are multiple pieces of legislation under consideration, some of which are equally draconian in effect even if different in methodology.  LUGPA will continue to closely monitor activity in both the legislative and administrative branches of government and will support all legislative, regulatory, and legal efforts to ensure that our member practices continue to be able to provide essential medications in the office setting.

The proposed rule is available to read on the Federal Register.