In legislation passed by both chambers of Congress Jan. 1, the cost of a one-year reprieve from sharp cuts to Medicare physician payments, scheduled to begin in 2013, would be offset by a reduction in Medicare’s bundled payment for end-stage renal disease. The reduced payment would take into account a drop in the use of erythropoiesis-stimulating agents observed over the last several years.

There was lots of criticism of pharmacy benefit managers (and a fair amount of pharmaceutical manufacturers) at the oversight hearing. However, Democrats may be more cautious about preserving the benefits PBMs provide versus the downsides in developing reforms.

New GAO recommendations springing from recent Medicare Part D cost and access trends related to rebates may not be relevant going forward because the IRA price negotiation program and benefit redesign will significantly change the landscape, HHS says.