Feds: Medicare drug costs going down

Jun 25th, 2018 | By | Category: News

Federal policies for Medicare health and drug plans for 2019 will save Medicare beneficiaries money on prescription drugs while offering additional plan choices, according to federal officials.

“The steps we are taking will drive more competition among plans and pharmacies to meet the needs of seniors and lower costs,” said Seema Verma, administrator of the federal Centers for Medicare and Medicaid Services (CMS).

Final policies announced in April include a reduction in the maximum amount that low-income beneficiaries pay for certain innovative medicines known as biosimilars. Other actions to lower the cost of prescription drugs, according to CMS, include:

  • Allowing for certain low-cost generic drugs to be substituted at any point during the year.
  • Increasing competition among plans by removing the requirement that certain Part D plans have to “meaningfully differ” from each other, making more plan options available.
  • Increasing competition among pharmacies by clarifying the “any willing provider” requirement, to increase the number of pharmacy options for beneficiaries.

CMS, part of the U.S. Department of Health and Human Services, also announced supplemental benefits in the Medicare Advantage program to include additional services that increase health and improve quality of life, including coverage of non-skilled in-home supports and other assistive devices. CMS officials said expanding the definition of “primarily health-related” will allow supplemental benefits if they compensate for physical impairments, diminish the impact of injuries or health conditions, and/or reduce avoidable emergency room utilization.

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