The Centers for Medicare and Medicaid Services (CMS) is planning to announce the finalization of a rule that could change how physicians are reimbursed for Medicare part B drugs (drugs administered in doctors’ offices) that are bought and billed by physicians and given to patients.

The regulation would combine newer, more innovative drugs with lower-cost generics into a single lump group for payment purposes. One type of innovative drugs, called 505(b)(2), are built on the research used to approve past medications, but add new technologies or improvements to the medication, like timed release. Examples of these medications are injected steroids for chronic pain and non-opioid alternative medications used for post-surgical pain.

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Your advocacy has made an impact.

Congress has directed the Department of Health and Human Services to disseminate the Pain Management Best Practices Report to providers and create a public awareness campaign about pain via the House Labor, Health and Human Services, and Education Committee Report accompanying the FY 2021 Budget Bill!

The report includes language we requested in our official appropriations submissions. (The language, with key sections underlined, is below.) Also included is our request to collect and report data on the prevalence of pain and various pain syndromes annually.

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