Staff Contact: Andrew Wheeler
CMS released a final part one guidance for the new Medicare Prescription Payment Plan. The guidance addresses topics such as identifying Medicare Part D enrollees who are likely to benefit from the program, the opt-in process, program participant protections and the data collection needed to evaluate the program. The guidance requires pharmacies to provide information about the program for anyone who meets a $600 out-of-pocket threshold based on a single prescription at the point-of-sale. Medicare Part D enrollees will be able to opt into the new program for the 2025 plan year. MHA published an issue brief with details.