Closing the 'doughnut hole': Part D beneficiaries could see big drug savings in 2011
The Centers for Medicare & Medicaid Service has issued new guidance to Medicare Part D plan sponsors to guarantee that beneficiaries enrolled in the plans will see 50 percent savings on their brand name and some authorized generic drugs when they enter the coverage gap during 2011.
In a notice in the Federal Register, CMS also issued the draft model agreement that drug manufacturers of applicable Part D drugs will sign in order to participate in the discount program.
Closing the coverage gap is one of the many purposes of the Patient Protection and Affordable Care Act of 2010, signed by President Obama earlier this year. Efforts began with a one-time check for $250 for those that reach the donut hole in 2010 and are not eligible for low-income assistance. Beneficiaries will also receive a 50 percent discount for brand-name and some authorized generic drugs beginning in 2011 and additional savings until drugs are covered throughout the coverage the gap by 2020.
"The documents we are releasing facilitate the implementation of the Affordable Care Act's provisions to help Medicare beneficiaries with the high costs of their prescription medicines," said CMS deputy administrator and director of the Center for Medicare Jonathan Blum.
According to officials, the Part D plan guidance was finalized after receiving comments on the draft guidance that was issued on April 30. It clarifies how the discount program will be implemented and that CMS will coordinate the manufacturers' reimbursement for discount payments that Part D sponsors provide on their behalf to applicable beneficiaries under this program through a third-party administrative contractor. The third-party administrator will also help to verify the accuracy of the manufacturer discounts reported by Part D sponsors.
CMS will host a public meeting on June 1 to discuss and collect public feedback about the draft manufacturer agreement, and to gather feedback about the final Part D guidance.
