Fact Sheet | Pricing

Part B International Drug Pricing Model for Medicare Part B Drugs

Fact Sheet | Pricing

Part B International Drug Pricing Model for Medicare Part B Drugs

The International Pricing Index (IPI) Model would initially focus on Part B single source drugs, biologicals, and biosimilars that encompass a high percentage of Part B drug utilization and spending. The CMS Innovation Center would test this model under section 1115A of the Social Security Act (the Act), which authorizes testing models expected to reduce program expenditures, while preserving or enhancing the quality of care furnished to beneficiaries. The model under consideration would include physicians, hospitals, and potentially other providers and suppliers in selected geographic areas.

Download the fact sheet

Advertisements

Related Articles | Pricing

Trend | Contracting

Why removing percent-of-charge provisions in managed care contracts won't address concerns about high hospital charges

Removing percent-of-charge provisions in favor of fixed fees would not remove the factors that drive price increases, nor would it reduce administrative hassles or decrease risk.

Fact Sheet | Pricing

Hospital Negotiated Charge Posting Requirement Final Rule Summary

On Nov. 15, 2019, CMS released a final rule that establishes the requirements for hospitals operating in the United States to establish, update, and make public a list of their standard charges for the items and services they provide.

Fact Sheet | Pricing

Health Plan Price Transparency in Coverage Proposed Rule Summary

HFMA provides a detailed summary of proposed rule requiring group health plans and health insurance issuers to disclose, upon request, cost-sharing amounts.

Fact Sheet | Pricing

Health Plan Price Transparency Requirements Proposed Rule Executive Summary

On November 15, 2019, CMS issued a proposed rule that, if finalized, would require health plans to make an online price transparency tool that provides cost sharing and other information available to their members.