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Most Favored Nation Drug Pricing Model

On Friday, November 20, 2020, the Centers for Medicare & Medicaid Services (CMS) released the Most Favored Nation (MFN) Model Interim Final Rule with Comment Period (IFC). The Model is mandatory for all Medicare physicians, non-physician practitioners, supplier groups (such as group practices), hospital outpatient departments (including 340B covered entities), ambulatory surgical centers, and other providers and suppliers that receive separate Medicare Part B fee-for-service payment for the Model’s included drugs, with certain exceptions.

A policy that ties Medicare payment for outpatient drugs to international prices, if implemented without broader payment reform and over an extended period, could have a devastating impact on cancer programs across the country. This proposal will reduce or eliminate these Medicare beneficiaries’ access to appropriate care and exasperate health inequities.

MFN Drug Pricing Timeline:

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Christian Downs Headshotbegin-quote"This Interim Final Rule is impractical, unworkable and does not address the reforms necessary to protect Medicare beneficiaries and strengthen the cancer delivery infrastructure. It will have a disproportionate impact on smaller hospitals and practices which are already struggling due to the COVID-19 pandemic and force them to curtail services and access to ensure their viability."

Christian G. Downs, JD, MHA,
Executive Director
Association of Community Cancer Centers 

Featured Program

Alternative Payment Models Coalition

The ACCC Alternative Payment Models Coalition builds off ACCC’s past Oncology Care Model Collaborative by addressing the broader interest in alternative payment models (APMs) beyond the OCM. This initiative will focus on addressing concerns about lack of preparedness to perform under these payment models, patient and provider access to the latest treatments, infrastructure, and long-term sustainability. This will be inclusive of medical, radiation, and surgical oncology and all respective APMs.
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