Summary
Within its calendar year (CY) 2019 hospital outpatient prospective payment system proposed rule, the Centers for Medicare and Medicaid Services (CMS) includes a Request for Information (RFI) on how to structure a Competitive Acquisition Program (CAP)-type model for Part B drugs through the Center for Medicare and Medicaid Innovation (CMMI).
Wynne Health Group has prepared an issue brief (attached) to provide an overview of what the agency is considering and where it is seeking stakeholder input by the Sept. 24, 2018 comment deadline. In the RFI, the agency asks numerous questions about design considerations for a CAP-like model, such as drugs and biologics that could be included, what role private-sector vendors should play, the appropriate scope of a demonstration, and other issues.