CMS Announces Part D Plans will Lower the Cost of Prescription Drugs in 2019
The Centers of Medicare & Medicaid finalized changes to Medicare Part D drug plan policies for 2019. These changes will offer additional plan choices, as well as save Medicare beneficiaries money on their out of pocket prescription drug costs.
In 2018, a new rule helped beneficiaries save on coinsurance on Part B drugs that were administered during a hospital stay, if the hospital was participating in the 340B program. This program reduced the amount Medicare was paying for those drugs. Thus, reducing the cost to beneficiaries. Beneficiaries are savings $320 million on out of pocket drug expenses in 2018, and these savings are expected to increase in 2019.
“The Trump Administration is taking steps for seniors with Medicare to save money on prescription drugs,” said CMS Administrator Seema Verma. “The steps we are taking will drive more competition among plans and pharmacies to meet the needs of seniors and lower costs.”
Changes to lower the cost of prescription drugs include:
- Lowering the maximum amount low-income beneficiaries are paying for specific medicines known as “biosimilars.”
- Increasing the number of pharmacy options with the “any willing provider” requirement.
- Increasing competition among Part D plans to make more plan options available by removing certain requirements.
- Allowing some generic drugs to be substituted at any point throughout the year as well as reducing cost sharing.
Ending the Opioid Epidemic
CMS is also responding to the Opioid epidemic by providing Medicare with new tools to fight Opioid abuse. Such as, requiring beneficiaries that are at risk of overuse or addition to use specific pharmacies to fill their prescriptions.
Patients Overwork Paperwork Initiative
- Permit plans to satisfy disclosure requirements by using electronic posting
- Improve transparency of 5 star plan ratings
- More efficiently provide approval of marketing materials
The final rule can be downloaded from CMS.gov