Medicare Part D Protected Classes Targeted in Last-Minute Payment Demo Update
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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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?
Becerra Takes The Helm At HHS; More Visibility On Administration’s Drug Pricing Priorities To Follow
Becerra’s HHS has a new crop of former Capitol Hill staffers in its policy ranks who are well versed on legislation in the health care realm, including prescription drug pricing reform. That will help advance the Administration’s agenda.
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.