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Medicare Preparing Rule to Ensure Swift Access to COVID Vaccine

Posted on Wednesday, October 14, 2020
by Outside Contributor

The Centers for Medicare & Medicaid Services has a plan to ensure full payment for and speedy access to new Covid-19 vaccines and treatments for Medicare beneficiaries, agency Administrator Seema Verma said Tuesday at a virtual conference.

Although Congress has made clear it wants Medicare to cover the cost of a Covid-19 vaccine without cost-sharing, Verma said it can take one to three years to work out payment issues for vaccines and other treatments due to agency’s “very deliberative processes,” which, “unfortunately, can delay putting access to important treatments, innovative technology in the hands of our beneficiaries.”

So the agency is working on a rule to address this “because we want to make sure that our payment policies aren’t standing in the way of beneficiaries having access to the latest treatments,” Verma said in an interview with former CMS Administrator Mark McClellan during the Health Care Payment Learning and Action Network Virtual Summit.

She said the CMS is working to ensure that “as FDA is giving approvals for new medications, that we are paying for these innovative treatments appropriately.”

The agency has also been working to meet Congress’ goal of having Medicare provide full payment for a Covid-19 vaccine, Verma said.

“I think you’ll see more from the agency by the end of the month on this issue. I think we’ve figured out a path forward,” Verma told McClellan.

Verma said the agency is working to make sure there are “no barriers to individuals getting vaccines” in Medicare or Medicaid.

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