CMS Issues Draft Guidance on New Program to Allow People with Medicare to Pay Out-of-Pocket Prescription Drug Costs in Monthly Payments

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CMS Issues Draft Guidance on New Program to Allow People with Medicare to Pay Out-of-Pocket Prescription Drug Costs in Monthly Payments
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New Medicare Prescription Payment Plan will help people pay Medicare Part D costs over the year instead of all at once

President Biden’s prescription drug law, the Inflation Reduction Act, gives people with Medicare prescription drug coverage the option to pay out-of-pocket costs in monthly payments spread out over the year, starting in 2025. Today, the Centers for Medicare & Medicaid Services released draft guidance for comment that outlines the requirements and procedures for certain aspects of the new Medicare Prescription Payment Plan.

“People with Medicare are already feeling the benefits of the prescription drug law — such as free recommended vaccines and lower costs for insulin,” said CMS Administrator Chiquita Brooks-LaSure. “The draft guidance CMS is releasing today is an important step in standing up a new program that will help certain people with Medicare prescription drug coverage who have high upfront drug costs.”

Given the size of the new program, CMS is releasing the guidance in two parts, starting with the guidance released today. Additional draft guidance will be released for comment in early 2024. The second part of the guidance will focus on Medicare Part D enrollee outreach and education, Medicare Part D plan bid information, and monitoring and compliance.

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