IRA

On March 26, the Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced 41 prescription drugs covered under Medicare Part B that may have lower beneficiary coinsurances. From April 1, 2024, through June 30, 2024, some people with Medicare who take these drugs may save between $1 and $3,575 per average dose, depending on the beneficiary’s coverage. Under the Inflation Reduction Act, signed into law in August 2022, drug companies that raise their drug prices faster than the rate of inflation are required to pay a rebate to Medicare. Starting April 1, 2023, Medicare beneficiaries may pay a lower coinsurance for certain Part B drugs if the drug’s price increases...

On Monday, February 12, the Centers for Medicare & Medicaid Services (CMS) released an updated State Medicaid, Children's Health Insurance Program (CHIP), and Basic Health Program Vaccine Toolkit. This updated toolkit serves as a consolidated and comprehensive compilation of vaccination policies, including related flexibilities and coverage and payment requirements, for states to consider as they transition away from the COVID-19 public health emergency and implement Inflation Reduction Act coverage requirements. It also includes additional considerations states may make to enhance vaccination coverage and access, including provider qualifications, immunization registries, and payment considerations.

AARP recently released an analysis examining existing state pharmaceutical assistance programs (SPAPs) and their characteristics, highlighting how specific federal prescription drug reforms could generate savings for SPAPs. SPAPs are state-run programs that help pay prescription drug-related costs for certain populations with limited financial resources, including older adults. Today, 13 states operate a SPAP to help older adults afford their prescription drugs, down from 23 SPAPs in 2004. Prescription drug reforms enacted as part of the Inflation Reduction Act (IRA) that will be implemented over the next several years will affect SPAPs and could lead to savings for the programs. While none of the law’s provisions directly address SPAPs...

On January 31, the U.S. Department of Health and Human Services’ (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) released a report titled “Medicare Enrollees and the Part D Drug Benefit: Improving Financial Protection through the Low-Income Subsidy.” The report highlights findings from an analysis of Medicare data from 2020, including that the Inflation Reduction Act’s (IRA) expanded financial assistance in Medicare’s Low-Income Subsidy (LIS) Program would have benefited nearly 461,000 Partial LIS enrollees had the provision been in effect in 2020. An additional 2.9 million Part D enrollees who were eligible but not enrolled in LIS would also have benefited from the program...