June 24, 2025
The Infusion Providers Alliance (IPA) recently provided comments to the Centers for Medicare & Medicaid Services (CMS) responding to draft guidance for Initial Price Applicability Year (IPAY) 2028, which is the first year Part B drugs will be subject to the Maximum Fair Price (MFP) payment methodology from the Inflation Reduction Act (IRA). Our comments can be viewed here.
In our comments, we outlined grave concerns about the potential impact to IPA providers and their ability to continue to serve patients who need access to Part B drugs under Secretarial negotiation under the IRA. Because the key part of IPA members’ reimbursement for drug administration is tied to the price of the drug through the “add-on” payment to the average sale price (ASP) plus 6 percent payment methodology, policies that substantially reduce that add-on payment will have enormous negative ramifications to our providers and the patients we serve.
We urged CMS to clarify through regulation that the MFP will not impact the ASP reimbursement methodology for commercially insured patients. The law’s silence on this issue does not give CMS the authority to crosswalk pernicious pricing schemes from Medicare into private reimbursement payment methodologies.
About the Infusion Providers Alliance
The Infusion Providers Alliance (IPA) is committed to protecting the integrity of the provider-patient relationship by empowering providers and patients to choose the most appropriate treatment together. We advocate for policies that ensure timely and adequate patient access to high quality care in IPA members’ convenient, community-based, non-hospital settings. IPA members operate over 1,000 in-office or stand-alone ambulatory infusion centers across 43 states nationwide, delivering value to the health care system and improved outcomes to patients.
All inquiries should be emailed to ewarren@infusionprovidersalliance.org.