The new plan, starting in 2025, will allow people with Medicare to pay out-of-pocket prescription drug costs in monthly payments. The latest guidance focuses on outreach, education, and communication requirements.
The Centers for Medicare & Medicaid Services (CMS) on Thursday released the second part of draft guidance documents for the new Medicare Prescription Payment Plan.
The program, which will start in 2025, is part of the Inflation Reduction Act, which gives people with Medicare prescription drug coverage (Medicare Part D) the option to pay out-of-pocket costs in monthly payments over the course of the year.
CMS released the first draft guidance in August 2023, which focused on helping Medicare Part D plan sponsors and pharmacies prepare for the new program and build the necessary infrastructure for successful implementation. The new draft guidance outlines outreach, education, and communications requirements to ensure seniors are aware of the Medicare prescription payment plan.
“Older Americans and people with disabilities who have experienced sticker shock from high prescription drug prices will have the option in 2025 to spread out-of-pocket costs out over the year, rather than paying all at once,” said Meena Seshamani, M.D., Ph.D., CMS deputy administrator and director of the Center for Medicare, in the announcement. “This specifically helps alleviate cash flow issues for people who face high out-of-pocket costs early in the year that may prevent these individuals from taking a drug that could keep them healthy. The draft guidance we have released is a blueprint to help operationalize this program to ensure both health care organizations and people with Medicare are empowered and educated. That way, people in Medicare can make the best choices for their health and financial needs.”
CMS is seeking comments on the second part of draft guidance. Comments will be accepted through March 16 and will be considered during development of the final guidance.
For additional information, see the CMS fact sheet, implementation timeline, and the draft guidance document.