The EACH/PIC Coalition submitted comments to CMS on the Medicare Negotiation Program procedures for IPAY 2028. The comments provided input on improving patient roundtables, better incorporating patient input, protecting patient access to medications, and ensuring physician reimbursement rates are adequate.
The comments stated:
“Patients and patient organizations who participated in the roundtables and town halls are appreciative for the opportunity to ensure our voices were counted. However, as we enter into the third round of negotiations, we continue to be discouraged by the lack of transparency regarding how patient input impacts CMS decision making. It is still completely unclear how or if CMS utilizes information provided by patient voices. Given that patients are the ultimate consumers and their health could be directly impacted, their testimony and input should be utilized as a key factor in how negotiation is implemented.”
“The process to apply for the sessions was once again complicated and cumbersome. Several participants expressed concern upon reading they were required to disclose their home addresses. First, many questioned, “Is CMS coming to my house?” While we assured them they are not, this likely deterred others from participating. Given this information is not related to the sessions in any way, CMS should revise their standard forms and tailor them to these events and a patient audience.”
“Under IPAY 2028, drugs covered under Part B will be subject to negotiation for the first time, and we encourage CMS to carefully consider how provider reimbursement rates could impact patient access. Physician reimbursement rates are already being squeezed. If these rates are lowered further due to negotiation, opportunities for treatment costs to be recouped by providers will also decrease. As a result, physicians could be forced to adjust treatment recommendations to avoid facing financial deficits, leaving patients with fewer treatment options.”