Weekly Policy Update: Colorado Special Legislative Session + Interim Final Rule on Most Favored Nation Payment Model

Yesterday Governor Polis called a Special Session of the General Assembly to discuss an economic stimulus package that he said cannot wait until January. The session is scheduled to begin on November 30 at 10 am, and the Governor is asking the legislature to take action on seven areas:

  • Direct support and tax relief to small businesses, including gyms, restaurants, bars, arts + culture venues, and event-related businesses
  • Childcare support
  • Housing and rental assistance
  • Expanding broadband access
  • Food insecurity
  • Utilities assistance
  • Public health response

CBSA will keep our members updated on any developments impacting our life sciences community during the Special Session.

Read the Executive Order calling for the Special Session here.

Trump Administration Releases Most Favored Nation Rule for Medicare Part B

Today the Centers for Medicare and Medicaid Services (CMS) released their interim final rule implementing the Most Favored Nation (MFN) payment model for Medicare Part B.

The mandatory MFN model will test paying part B drugs at the lowest adjusted price paid by any OECD country that has a GDP per capita that is at least 60% of the U.S. GDP per capita. Those countries include:

Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Iceland, Ireland, Israel, Italy, Japan, Republic of Korea, Luxembourg, Netherlands, New Zealand, Norway, Spain, Sweden, Switzerland, and the United Kingdom.  

The model will also test a redesign of the percentage add-on payment structure under Medicare Part B through a flat per-dose add-on payment.

The MFN model will operate for seven years, starting January 1, 2021 to December 31, 2027. It will require participation of Medicare providers and suppliers that receive a separate Medicare Part B fee-for-service payment for the drugs included in the model.

You can view the CMS fact sheet on the interim final rule here.

CBSA is deeply concerned about this payment model, which systematically undervalues innovation. When the President announced his plans to move forward with this demonstration, we shared our strong opposition with members of the Colorado delegation and asked them to weigh in with the Administration. In particular, we stressed the impact this rule will have on patient access to innovative therapies and how it will reduce the incentive to invest in new medicines.

We are still reviewing the rule in more detail and coordinating with our national industry partners and the Council of State Bioscience Associations on our advocacy strategy. We will share additional updates with our community in the coming weeks.

Categories: CBSA News