SCMS is so impressed with a diabetes prevention pilot (covered by Managed Care here) that utilizes the YMCA that it wants to make the program available to all Medicare beneficiaries by January 2018, according to a final rule announced on Wednesday. Hospitals and doctors love the plan. Drugmakers, not so much, with the Pharmaceutical Research and Manufacturers of America (PhRMA) arguing that CMS is setting a flawed precedent by acting on preliminary data. It also worries that the program is on too much of a fast track.
Those complaints fell on deaf ears. Under the ACA, CMS Acting Administrator Andy Slavitt can expand, by regulation, successful demonstration programs that save money. Before the ACA, such a move required Congressional approval, and all the haggling and horse-trading that might involve.
Slavitt told USA Today: “I thought it was going to be one of the biggest home runs we were going to hit. Who could possibly be against preventing disease except for people who maybe manufacture drugs to fight disease?”
The price of insulin has risen at an extraordinary pace over the last few years. This is an especially hot topic when it comes to Medicare, inasmuch as it is estimated that a quarter of people 65 or older have the disease.
Source: CMS Final Rule