BETTER MEDICARE ALLIANCE URGES CONGRESS TO PURSUE PART D REFORM POLICIES
BMA ADVOCATES FOR FUNDAMENTAL POLICIES TO REDUCE OUT-OF-POCKET COSTS FOR MEDICARE BENEFICIARIES
Washington, D.C. – Better Medicare Alliance (BMA), the leading advocacy coalition for Medicare Advantage, sent a letter to House Ways and Means Committee and House Energy and Commerce Committee leadership on legislation to reform and improve Medicare Part D.
The letter, addressed to Ways and Means Committee Chairman Richard Neal (D-MA) and Ranking Member Kevin Brady (R-TX), Energy and Commerce Committee Chairman Frank Pallone, Jr. (D-NJ) and Ranking Member Greg Walden (R-OR), urged Congress to pursue fundamental improvements to the Part D program to reduce out-of-pocket costs for Medicare beneficiaries.
BMA supports a maximum out-of-pocket spending limit for Part D enrollees. In addition, BMA made clear in the letter that significant liability for the drug manufacturers is essential if we are to see lower prices for drugs. Not including manufacturers in meaningful cost liability in the catastrophic phase fails to reduce list prices and shifts the cost again to taxpayers and beneficiaries who can least afford it.
“Most Medicare beneficiaries have modest or fixed incomes and are not able to readily absorb high OOP costs associated with rising prescription drug prices,” said Allyson Y. Schwartz, President and CEO of the Better Medicare Alliance (BMA). “Unlike the current Part D program and traditional fee-for-service (FFS) Medicare, Medicare Advantage has a maximum OOP limit that protects beneficiaries from catastrophically high OOP costs. We support extending this protection to all Part D enrollees in a way that does not destabilize premiums or increase costs to taxpayers or beneficiaries.”
In the letter, BMA also supported the following additional tools to reduce drug costs:
- Additional protected class flexibilities to Part D plans, including the ability to include one drug per class in formularies and to allow prior authorization for off-label use of certain protected class drugs.
- Establishment of preferred and non-preferred specialty tiers, with more utilization management tools used for drugs on the non-preferred tier; and (2) using “split-fills,” or initial supplies of prescription drugs that cover fewer than 30 days.
- Stronger rewards and incentives to encourage beneficiaries to use lower-cost options – such as generics and biosimilars – when available and appropriate.
Read Full Letter HERE.