CMS Should ‘Clarify’ That Part B Inflation Rebates Do Not Apply In Medicare Advantage, Pharma Urges

The Centers for Medicare and Medicaid Services is considering imposing price inflation rebates on Part B drugs furnished to enrollees in Medicare Advantage plans in addition to those covered by fee-for-service Medicare.

  
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The Centers for Medicare and Medicaid Services is considering imposing price inflation rebates on Part B drugs furnished to enrollees in Medicare Advantage plans in addition to those covered by fee-for-service Medicare.

Price in clamp (clipping path included) - Illustration
Prices Squeezed By Inflation Rebates

The US Centers for Medicare and Medicaid Services has no legal basis to move ahead with a policy to incorporate drugs covered by Medicare Advantage plans into the calculation of price inflation rebates in Medicare Part B, according to the Pharmaceutical Research and Manufacturers of America.““”““”

Key Takeaways

  • Pharma strongly opposes CMS’ suggestion that it may impose price inflation rebates on drugs covered by Medicare Advantage plans in addition to those covered by traditional Medicare.

“CMS does not have authority to include units of Part B rebatable drugs furnished to MA enrollees in the calculation...

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CMS Should ‘Clarify’ That Part B Inflation Rebates Do Not Apply In Medicare Advantage, Pharma Urges

The Centers for Medicare and Medicaid Services is considering imposing price inflation rebates on Part B drugs furnished to enrollees in Medicare Advantage plans in addition to those covered by fee-for-service Medicare.

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