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Medicare Part D Protected Classes Targeted in Last-Minute Payment Demo Update

Executive Summary

If not reversed by the Biden Administration, demo program that puts plans at increased risk in catastrophic phase would also enhance negotiating leverage for drugs in the protected classes.

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CMS’ Likely Reversal Of Threat To Part D Protected Classes Doesn’t Mean Other Reforms Aren’t Coming

Concerns about reducing patient protections will resonate with the Biden Administration and the Medicare Part D protected classes aren’t major cost drivers anyway, Avalere’s Mendelson says.

Biden Regulatory Freeze May Pause Sunset Rule, Medicare Rebate, Medicaid Line Extension Regs

Tactic aims to allow incoming Administration to scrutinize so-called ‘midnight rules’ issued in the final days of the Trump Administration before they take effect. Regulators may also solicit stakeholder comments on delayed rules.

Medicare Payment Model Experimentation Under Biden Administration ‘Pretty Wide Open’

Former CMS acting administrator Andy Slavitt says agency’s direction during Biden administration depends on nominee, but trust fund’s looming insolvency will be ‘an issue you can’t avoid.’ The president’s priorities around health equity, racial justice and mental health will make their way into CMS policy and demonstration models, Slavitt suggests.

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