We use cookies to give you the best online experience. By using our website you agree to our use of cookies in accordance with our cookie policy. Learn more here.Close Me
To understand the policy challenge created by repeal of the non-interference clause,
consider this simple example. Acme Drug Company brings a drug
to the market as a single source innovator. Essentially, they
are without generic competition. Acme prices their drug at
$100. Random Insurance Company wants to purchase the drug at
$90 for beneficiaries in their Medicare Advantage Prescription Drug
Plan. Currently, many would argue that the flaw in the
Medicare drug payment system is that Acme has the leverage to tell
Random 'no' to their request for a lower drug price.
So what exactly does the entry into the conversation of "government negotiation"
entail? If CMS or some other duly appointed federal authority
steps in between Acme and Random, what power does it have?
This is the challenge of non-interference repeal. Unless you
assume that the intervention of federal authority brings with it
some ability to force Acme to lower its price, repealing
non-interference, in and of itself, is meaningless. The
federal authority can ask Acme nicely. The federal authority
can say "pretty please." But if Acme retains the
right to say "$100," the federal authority produces no
savings to the taxpayer.
For repeal of the non-interference clause to be
meaningful, the federal authority must be invested with tools to
force Acme to lower its price. The mechanisms the federal
authority require involve potentially uncomfortable policy
choices. Repealing the non-interference clause is not
enough. Make no mistake about it: repealing non-interference
in a way that achieves lower drug pricing requires providing the
federal government with extensive powers and the mandate to use
them.
The content of this article is intended to provide a general
guide to the subject matter. Specialist advice should be sought
about your specific circumstances.
To print this article, all you need is to be registered on Mondaq.com.
Click to Login as an existing user or Register so you can print this article.
Legal adult-use marijuana is associated with risks that may cause bodily injury and property damage. Many of these risks have been well documented and widely discussed in the media, ...
On September 14, the Centers for Medicare & Medicaid Services (CMS) announced its newly designed Medicare card and informed all Medicare beneficiaries to look for their new card in the mail.
In an executive order dated October 12, 2017, President Trump outlined a number of items aimed at "promoting healthcare choice and competition across the United States."
On October 5, 2017, the Honorable Judge John Walter of the United States District Court, Central District of California, granted the Defendants' Motion to Dismiss the Medicare Advantage ("MA")...
The "rigorous" materiality requirement in False Claims Act cases post-Universal Health Servs., Inc. v. United States ex rel. Escobar just cost a relator millions of dollars.
the past six months, the number of cybersecurity attacks have increased around the globe, many of which have specifically impacted the healthcare industry.
Register for Access and our Free Biweekly Alert for
This service is completely free. Access 250,000 archived articles from 100+ countries and get a personalised email twice a week covering developments (and yes, our lawyers like to think you’ve read our Disclaimer).
A Conversation On CMS' Emergency Preparedness Compliance For Healthcare Providers (Video)
