ADVI Analysis: MedPAC April 2024 Meeting

MedPAC held a meeting April 11-12, 2024 (link). The following relevant topics were discussed: 

• Telehealth in Medicare: Status report 
• Considering approaches for updating the Medicare physician fee schedule 
• Assessing consistency between plan-submitted data sources for Medicare Advantage enrollees 
• Generic drug pricing under Part D 
• Initial findings from analysis of Medicare Part B payment rates and 340B ceiling prices 

ADVI Angle

Key takeaways from the April meeting include:

• Telehealth in Medicare: Status report
  • Staff provided an overview of current telehealth policies in the Medicare program, stakeholder viewpoints on the benefits of telehealth, and alternatives to the current in-person visit requirement. Commissioners supported coverage of telehealth services, emphasizing its importance in increasing accessibility to behavioral health services. 
• Considering approaches for updating the Medicare physician fee schedule
  • Staff presented policy approaches for updating the PFS. Commissioners reviewed and discussed the policy approaches, including an alternative to payment in advanced alternative payment models (A-APMs). 
• Assessing consistency between plan-submitted data sources for Medicare Advantage enrollees
  • Staff presented data discrepancy between encounter data and plan-submitted data. Commissioners discussed possible measures to ease the administrative burden of data collection and improve the scope of data reported. 
• Generic drug pricing under Part D
  • Staff presented findings on the impact of variation in Part D generic prices, determining that in most cases, generic point-of-sale (POS) prices indirectly affect beneficiaries and Medicare. Commissioners discussed the findings, focusing on the impact of consolidation on generic drug prices and accessibility of generic drugs. 
• Initial findings from analysis of Medicare Part B payment rates and 340B ceiling prices
  • Staff presented an analysis of estimated 340B ceiling prices, finding that aggregate payments by Medicare to 340B covered entities exceeded 340B ceiling price costs by 48 percent. Commissioners discussed the implications of the 340B program on hospital finances and unintended consequences that may occur from reducing 340B payment.

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