President Joe Biden's Inflation Reduction Act allows individuals with Medicare Part D prescription drug coverage to spread out-of-pocket costs over the year through monthly payments starting in 2025. The Centers for Medicare and Medicaid Services released draft guidance outlining the procedures for the new Medicare Prescription Payment Plan, according to an Aug. 21 news release.
“For people with Medicare Part D who face high costs early in the year, today’s announcement will ease the burden of out-of-pocket prescription drug costs,” HHS Secretary Xavier Becerra said in the release. “This is one more example of how the president’s prescription drug bill is reducing costs and increasing access to life-saving medicines for our Medicare beneficiaries.”
These guidelines outline the stipulations and processes pertaining to certain aspects of the new Medicare Prescription Payment Plan, the release reported. By enabling Medicare beneficiaries, including seniors and individuals with disabilities, to evenly distribute the financial burden of prescription drug costs throughout the year, this program could alleviate the weight of substantial upfront expenses.
"Medicare beneficiaries are already reaping the rewards of the prescription drug law, such as cost reductions for insulin and free recommended vaccines," CMS Administrator Chiquita Brooks-LaSure said in the release. "The draft guidance released by CMS today marks a significant stride toward launching a novel program that will offer assistance to specific Medicare beneficiaries with Part D prescription drug coverage who encounter considerable upfront drug expenses."
This preliminary guidance primarily serves to aid Medicare Part D plan sponsors and pharmacies in readiness for the forthcoming program. It aims to facilitate the establishment of necessary infrastructures for seamless program execution, according to the release.
The draft guidance addresses key topics, including the identification of potential beneficiaries within Medicare Part D, the process for Part D enrollees to opt into the program, safeguards for program participants and the data compilation required for program evaluation, the release said. Feedback is sought on these topics, as well as strategies to ensure eligible Part D beneficiaries maximize the benefits of programs like Medicare Savings Programs and Extra Help, aimed at reducing their out-of-pocket prescription drug expenditures.
Acknowledging the scale of the program, CMS is releasing the guidance in two phases, commencing with the guidance disclosed today. Additional draft guidance will be presented for public input in early 2024, the release reported.
The second phase will concentrate on outreach and education for Medicare Part D enrollees, information regarding Medicare Part D plan bids, as well as monitoring and compliance. CMS intends to develop tools, including calculators, to aid Medicare Part D beneficiaries and their caregivers in estimating potential monthly payments under the new program, the release said.
