CMS revised guidance for Medicare Prescription Drug Inflation rebate program

As a result of US President Biden’s much industry contested prescription drug law, the Inflation Reduction Act, drug companies will pay rebates to Medicare when prices of certain prescription drugs administered or dispensed to people with Medicare increase faster than the rate of inflation.

In addition, people with Medicare may pay a lower co-insurance for some Part B drugs if the drugs’ prices increase faster than the rate of inflation.

Yesterday, the Centers for Medicare & Medicaid Services (CMS) released revised guidance detailing key requirements and procedures for calculating rebates and invoicing manufacturers that owe rebates to Medicare under the Medicare Prescription Drug Inflation Rebate Program for certain drugs covered under Medicare Part B and Part D. CMS also released the list of 48 prescription drugs for which Part B beneficiary coinsurances may be lower between January 1, 2024 – March 31, 2024. Some people with Medicare who take these drugs may save between $1 and $2,786 per average dose starting January 1, 2024, depending on their individual coverage.