AHIP Submits Comments on Medicare Advantage and Part D Drug Pricing Rule

On January 25, AHIP submitted a comment letter to the Centers for Medicare & Medicaid Services (CMS) on a proposed rule intended to lower prices for prescription drugs and out-of-pocket costs for beneficiaries in the Medicare Advantage (MA) and Part D programs. Our letter expresses strong support for provisions that would allow Part D plans to expand the use of clinically-appropriate, evidence-based medical management and formulary tools for certain high-cost “protected class” drugs and employ such tools for physician-administered medications covered by MA plans. However, we also raise serious concerns with other provisions of the proposed rule.