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Patient Access & Reimbursement – Biocom California Advocacy

Position Overview

Biocom is committed to ensuring that patients have access to the care they need and supports reimbursement policies that provide appropriate and inclusive coverage, coding, and payment for biopharmaceutical, medical device, diagnostic, and genomics products. Coverage and coding limitations, outdated Medicare regulations, restrictive formularies, and increased cost-sharing such as specialty tiers and high deductibles, among others, inhibit both the development of breakthrough technologies and their use by providers, which in turn limits patients’ access to life-enhancing and life-saving products. Reimbursement systems should reward innovative modes of health care delivery that result in quality improvement and cost reduction and, most importantly, save lives.

Medicare Part B

Biocom has strongly opposed the $3 billion cuts to Medicare Part B reimbursements to physicians mandated by the sequester, and continues to oppose proposals that would cut the current market-based average sales price reimbursement system for physicians (ASP+6 percent), which has successfully reduced Medicare costs since its inception. Further cuts to Medicare Part B will increase the likelihood that physicians will stop providing critical treatments to the most vulnerable patients.

Medicare Part D

Biocom is opposed to cuts and changes to the Medicare prescription drug benefit program (Medicare Part D), a successful program covering more than 90 percent of Medicare beneficiaries with comprehensive drug coverage. Proposals to impose rebates and price controls to Medicare Part D will likely destabilize the program and decrease industry incentives to invest in new drugs’ research and development.

Biocom Policy Statements

  • Biocom 340B Drug Discount Program – Download
  • Biocom Comment Letter – RFI Blueprint to Lower Drug Prices – Download
  • Biocom Comments to CMS on Protected Classes – Download
  • Biocom Drug Costs Infographic – Download
  • Joint Medicare Part B Demo Rule Letter to Congress – Download
  • Joint Medicare Part B Demo Rule Comments to CMS – Download
  • Biocom 2018 CLFS Rates Comments to CMS – Download