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

 

Submissions: 

AARP

AIDS Institute 

America's Health Insurance Plans
Attachment

American Academy of Dermatology Association 
Attachment

American Academy of Neurology

American Cancer Society Cancer Action Network

American College of Physicians - 1

American College of Physicians - 2

American College of Rheumatology 

American Diabetes Association 

American Geriatrics Society

American Lung Association

American Medical Association

American Society of Clinical Oncology 

Arnold Ventures

Arthritis Foundation 

Association for Accessible Medicines

Astellas Pharma

AstraZeneca

Better Medicare Alliance

Biotechnology Innovation Organization

Bipartisan Policy Center

BlueCross BlueShield Association

California Life Sciences Association 

Campaign for Sustainable Rx Pricing

Cancer Leadership Council

Cancer Support Community 

Center for Medicare Advocacy

Consumers for Quality Care and the National Hispanic Council on Aging 

Council for Affordable Health Coverage 

Cystic Fibrosis Foundation 

Exelixis, Inc.

EmblemHealth

Families USA

Gilead Science

International Brotherhood of Teamsters Voluntary Employee Benefits Trust

Johnson & Johnson

Justice in Aging

Leukemia & Lymphoma Society 

Mallinckrodt Pharmaceuticals

MAPRx Coalition

Medicare Rights Center

Michael J. Fox Foundation for Parkinson’s Research

Mylan

National Alliance on Mental Illness

National Association of Chain Drug Stores 

National Association of Nutrition and Aging Services Programs

National Community Pharmacists Association 

National Council on Aging

National Health Council

National Hemophilia Foundation 

National Hispanic Council on Aging

National Home Infusion Association

National MS Society

National PACE Association 

National Patient Advocate Foundation 

Patients For Affordable Drugs, Patients For Affordable Drugs NOW

Patients Rising

PCMA

Pfizer

PhRMA

Public Citizen

Puerto Rico Statehood Council

Rare Access Action Project

Rep. Jenniffer Gonzalez-Colon (PR-AL)

Sanofi

Stacie B. Dusetzina, PhD - Vanderbilt University School of Medicine

Susan G. Komen

Tara O'Neill Hayes - American Action Forum