Medicare Will Pick Up Tab Initially For Lower Part B Coinsurance Resulting From Price Inflation Rebates
Centers for Medicare and Medicaid Services ensures that providers won’t be short-changed if beneficiary cost sharing is lowered because price inflation rebates are applied against drug costs.
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Biden Administration releases first list of Part B drugs subject to inflation rebates; others to follow on quarterly basis. Medicare won’t invoice sponsors until 2025, but patients could see coinsurance reductions next month.
Coinsurance for Part B drugs may reflect rebates by April, and sponsors are already liable for them, but payments will be delayed several years as CMS develops its systems. Agency seeks comment on how to account for 340B discounts and make allowances for drug shortages, among other issues.
Congressional Democrats achieved a long-sought goal in passing major legislation to control drug prices in Medicare. A complete lack of Republican support suggests the programs established by the bill will face the same kind of legislative and legal challenges that confronted the Affordable Care Act, which was enacted in a similar manner.