Under the Medicare Drug Rebate provisions of the Inflation Reduction Act (IRA), beneficiary coinsurance will be 20% of the inflation-adjusted payment amount for certain Part B drugs and biologicals with prices that have increased faster than the rate of inflation.

On Jan. 22, 2024, the Department of Health and Human Services (HHS) issued a letter to Medicare plans, health insurance issuers, and State Medicaid and CHIP programs (Letter) and a set of Frequently Asked Questions (FAQs) outlining how plans and issuers can make sure they meet their contraception coverage obligations.

The Inflation Reduction Act (IRA) requires the establishment of a new Medicare Part D manufacturer discount program (MDP) beginning Jan. 1, 2025 and requires participating manufacturers to enter into agreements with CMS by Mar. 1, 2024 in order to participate in the MDP in 2025. Agreements will be valid for not less than one year and automatically renew unless terminated by CMS or the manufacturer.

On Feb. 1, the Final Rule, titled Medicare and Medicaid Programs; Policy and Technical Changes to the Medicare Advantage, Medicare Prescription Drug Benefit, Program of AllInclusive Care for the Elderly (PACE), Medicaid Fee-For-Service, and Medicaid Managed Care Programs for Years 2020 and 2021, was published in the Federal Register.

On Dec. 14, 2022, CMS released the Calendar Year (CY) 2024 Part C and D Policy and Technical Proposed Rule. This proposed rule applies to Medicare Advantage (MA), Part D, Medicare cost plans, and Programs of All-Inclusive Care for the Elderly (PACE).

On Nov.7, 2022, the Centers for Medicare & Medicaid Services (CMS) issued guidance about the Inflation Reduction Act (IRA) changes to cost sharing requirements. The requirements are effective April 1, 2023 for Part B drugs with prices increasing faster than inflation and July 1, 2023 for the monthly Part B cost-sharing cap for insulins.