Solicitation for Feedback on Draft Medicare Part D Legislation
Ways and Means Committee Chairman Richard E. Neal and Energy and Commerce Committee Chairman Frank Pallone, Jr., along with Ranking Members Kevin Brady and Greg Walden are committed to lowering prescription drug costs for the 46 million patients who have Medicare Part D. As a part of that effort, the Committees will consider legislation to reform and improve the Medicare Part D program.
Medicare Part D has helped tens of millions of seniors and individuals with disabilities access life-saving therapies. However, Medicare beneficiaries across the country are facing high out-of-pocket costs for many medications, including insulin, even with Part D coverage.
Already this Congress, two committees have held several hearings with patients and experts from across the political spectrum to discuss options to lower prescription drug prices. Universally these witnesses agreed that Medicare Part D can and should be improved to lower costs both for the patients and for the Medicare program.
The bipartisan draft legislation would improve the Medicare Part D prescription drug program for beneficiaries and taxpayers alike. Specifically, the draft would create an out-of-pocket maximum on prescription drugs costs for Medicare beneficiaries in Part D based on the current catastrophic threshold. The draft would also right-size and modernize the incentive structure for Part D plans to better manage costs by reducing the government’s share of the catastrophic coverage from 80 percent to 20 percent over four years. The President’s FY 2019 and 2020 Budgets and the Medicare Payment Advisory Commission recommended these same changes.
The Chairmen and Ranking Members are soliciting feedback on this draft.
The comments could also include suggestions on additional changes that could be made to better align the Part D program’s incentives and improve the structure and benefits for Medicare beneficiaries and taxpayers, including changes to the coverage gap, the catastrophic threshold, liability in the catastrophic tier, promotion of lower-cost generic alternatives, improvements to the low-income subsidy program, and premium considerations.
Feedback is also requested on:
1) How the Part D program is addressing the problem of high cost drugs and how the program could better address the costs of these drugs. Specifically, whether or not Congress should consider changing or eliminating the distinction between the initial coverage phase and the coverage gap discount program;
2) What share of costs should be attributed to the beneficiary, Part D plans, and manufacturers under the current system and how this share should change if the liability were shifted for the manufacturer from the current coverage gap discount program to the catastrophic phase of the Part D benefit; and
3) What improvements the Committees should consider with respect to low-to-moderate income Part D beneficiaries and out-of-pocket costs below the catastrophic level.
Individuals or groups wishing to provide comment on this draft or additional issues related to Part D should submit specific comments by close of business Thursday, June 6, 2019, to the following email address: PartDImprovements@mail.house.gov