Part D Redesign: MedPAC Finalizes Recommendations To Congress But COVID-19 Will Get In The Way
Plan includes new 30% manufacturer discount in the US Medicare Part D catastrophic phase, which manufacturers will oppose as too high. But it also caps beneficiary cost sharing, a long-sought industry goal.
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A decision made more than 15 years ago by CMS to require drug insurance plans to cover all drugs for six specific diseases has proven impervious to change. But will the protected classes remain if Part D is reformed more broadly?
There won’t be a lot of legislative action in Congress in the weeks following passage of the $1.9tn American Rescue Plan. But the coming months are a critical time for the drug industry to try to set the terms for how it is treated in the next major bill later this year, and the stakes could not be higher.
That sound you hear is the staff of the US Medicare Payment Advisory Commission digging into new sources of data about the impact of rebates on the Part D outpatient drug benefit. Expect new policy ideas to follow – though not right away.