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>Medicare is legally restricted from negotiating drug prices. Why would Medicare negotiate rates for a therapy for infants/children (even if they had the legal

>Medicare is legally restricted from negotiating drug prices. Why would Medicare negotiate rates for a therapy for infants/children (even if they had the legal right)?

wombatpm 7y ago
Medicaid (for children and financially disadvantaged people ) is a state level program that is bolted onto Medicare. The Federal agency that oversees both is the CMMS Center for Medicare and Medicaid Services
- will_brown 7y ago
  FYI at least some state Medicaid programs do infact negotiate drug prices, unlike Medicare.
tareqak 7y ago
To bring down the cost? I'm confused as to what you are getting at: are you trying to say that if a therapy of infants and children exists at some cost determined by the producer of the therapy that Medicare is obliged to pay that price immediately and perform that therapy on the affected infants/children? In my understanding, certain procedures already have to go through some kind of approval before being eligible to be covered by Medicare in addition to FDA approval (I might totally be wrong here). Medicare negotiating the price would be an additional step. Update: Replies (I reached the maximum nesting level): 'chimeracoder: Thanks! I appreciate it. I keep forgetting that Medicare only applies to seniors. I guess individual insurance companies or the parents of the affected infants would be the ones to try to negotiate the price of this treatment then.
- chimeracoder 7y ago
  > To bring down the cost? I'm confused as to what you are getting at: are you trying to say that if a therapy of infants and children exists at some cost determined by the producer of the therapy that Medicare is obliged to pay that price immediately and perform that therapy on the affected infants/children? Medicare, with only a few exceptions[0], only covers people above a certain age (typically 65+). The original article is about a disease that affects infants. Almost no infants are eligible for Medicare. [0] none of which apply here

>Medicare is legally restricted from negotiating drug prices. Why would Medicare negotiate rates for a therapy for infants/children (even if they had the legal right)?

wombatpm 7y ago

Medicaid (for children and financially disadvantaged people ) is a state level program that is bolted onto Medicare. The Federal agency that oversees both is the CMMS Center for Medicare and Medicaid Services

will_brown 7y ago
FYI at least some state Medicaid programs do infact negotiate drug prices, unlike Medicare.

tareqak 7y ago

To bring down the cost? I'm confused as to what you are getting at: are you trying to say that if a therapy of infants and children exists at some cost determined by the producer of the therapy that Medicare is obliged to pay that price immediately and perform that therapy on the affected infants/children? In my understanding, certain procedures already have to go through some kind of approval before being eligible to be covered by Medicare in addition to FDA approval (I might totally be wrong here). Medicare negotiating the price would be an additional step. Update: Replies (I reached the maximum nesting level): 'chimeracoder: Thanks! I appreciate it. I keep forgetting that Medicare only applies to seniors. I guess individual insurance companies or the parents of the affected infants would be the ones to try to negotiate the price of this treatment then.

chimeracoder 7y ago
> To bring down the cost? I'm confused as to what you are getting at: are you trying to say that if a therapy of infants and children exists at some cost determined by the producer of the therapy that Medicare is obliged to pay that price immediately and perform that therapy on the affected infants/children? Medicare, with only a few exceptions[0], only covers people above a certain age (typically 65+). The original article is about a disease that affects infants. Almost no infants are eligible for Medicare. [0] none of which apply here