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Medicare Prescription Payment Plan (M3P) Implementation: Key Considerations for Part D Plan Sponsors and PBMs

Innovaare Compliance

The upcoming Medicare Prescription Payment Plan (M3P), set to launch in January 2025, marks a significant shift in Medicare’s approach to prescription drug coverage. Price Transparency: Increased transparency in drug pricing to enable beneficiaries to make informed decisions.

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Comments to CMS Guidance on the Medicare Prescription Drug Inflation Rebate Program Due March 11, 2023

Health Law Advisor

To advance these efforts, CMS established a Medicare Drug Rebate and Negotiations Group dedicated to the IRA and set forth the agency’s intended overarching timeline to implement the various IRA provisions, such as the Medicare Drug Price Negotiation Program and the Part D redesign.

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Monthly Round-Up of What to Read on Pharma Law and Policy

Bill of Health

County-level variation in cardioprotective antihyperglycemic prescribing among medicare beneficiaries. Reforming Patient Cost Sharing for Cancer Medications in Medicare Part D. New Reforms to Prescription Drug Pricing in the US: Opportunities and Challenges. Am J Prev Cardiol. 2022 Aug 2;11:100370. Lancet Oncol.

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CMS Releases Guidance on Implementation of Rebate Programs for Certain Medicare Part B and Part D Drugs

Healthcare Law Blog

The Rebate Programs are administered as part of the prescription drug affordability provisions of the Inflation Reduction Act (the “IRA”), which is aimed at “lower[ing] out-of-pocket drug costs for people with Medicare and improv[ing] the sustainability of the Medicare program for current and future generations.” [1]

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Magnolia Regional used price transparency IT to get more CHF patients to fill their prescriptions

Healthcare It News

"With prescription drug prices rising at every turn, patients need price transparency and the ability to discuss options with their doctors during office visits," Davis advised. ADVICE FOR OTHERS.

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A Health Consumer Bill of Rights: Assuring Affordability, Access, Autonomy, and Equity

Jane Sarashon

In addition to highlighting the Patient’s Bill of Rights, NABIP’s keynotes and general sessions will speak to similar topics being brainstormed at VIVE this week — including mental health, maternal health, pharmacy and prescription drugs (pricing, PBMs), population health, and Medicare and Medicaid innovations.

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Supreme Court Clarifies that Subjective (Not Objective) Knowledge of Falsity of Claim Dictates False Claims Act Liability

Healthcare Law Blog

In the underlying Seventh Circuit cases, relators alleged that retail pharmacies had knowingly submitted false reports of their Usual and Customary (“U&C”) drug prices to the government for reimbursement under Medicare Part D and Medicaid, because the reports allegedly did not account for discounted drug prices offered through certain prescription (..)