Medicare Part B Proposed Plan for Drug Reimbursement

Floor Speech

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Mr. CARTER of Georgia. Mr. Speaker, I rise today on behalf of seniors in the First Congressional District of Georgia. Many seniors in the First Congressional District of Georgia and across the Nation battle medically complex diagnoses, including cancer, rheumatoid arthritis, severe immune deficiency, epilepsy, and macular degeneration. These Medicare patients face significant complexities in their care and treatment options.

This spring, I joined over 240 of my colleagues in sending a letter to CMS that expressed our deep concerns with a sweeping, nationwide experiment that the Center for Medicare & Medicaid Innovation has proposed.

Patients and physicians in my district told me with no uncertainty that the CMMI experiment with part B drug payment will have negative consequences for millions of Medicare patients who depend on access to lifesaving treatments to live better lives. Under the part B drug experiment, in many cases, Medicare payment for certain drugs would be significantly below a physician's acquisition cost for the drug. This will put patients at tremendous risk, potentially forcing them to abandon treatments for other treatments that have shown less success. Ultimately, CMS will manipulate choice of treatment for Medicare patients using heavy-handed reimbursement techniques that undermine any efforts by medical professionals who have dedicated their lives to treating complex conditions like cancer.

To make matters worse, CMS sought little to no stakeholder input, and has provided little turnaround time before medication treatment will be based on cost, rather than what is best for the patient.

As a lifelong pharmacist, I trust clinically trained medical professionals to determine the best treatment for patients, not an unaccountable bureaucrat. Adding to the outlandish nature of this part B drug pilot project, there is nearly no escaping it. CMMI proposes to force nearly 75 percent of the country to participate in this Medicare drug experiment. 75 percent of the country is not a pilot project. It is near full implementation of a new program.

Just last week, CMS responded to the letter we sent them and simply thanked us for sharing our opinion. Such a brief and dismissive response is indifferent to the risk posed to our Nation's sickest patients and to this congressional body.

For all these reasons, I applaud my colleague from Indiana, Dr. Larry Bucshon, for sponsoring H.R. 5122 to prohibit CMS from moving forward with this dangerous, misguided experiment with seniors' lives. I proudly join him in his effort as a cosponsor of H.R. 5122 and encourage my colleagues to support this legislation.

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