CMS Empowers Patients with More Choices and Takes Action to Lower Drug Prices

The U.S. Centers for Medicare and Medicaid Services (CMS) announced Tuesday that, for the first time, it will give Medicare Advantage plans the option of negotiating for Part B drugs in a way that both reduces costs and increases the quality of care. For Medicare Advantage plans that also offer a Part D benefit, they will be able to cross-manage across Parts B and D, enabling patients to receive the best medicine whether it is physician-administered or self-administered. Additionally, CMS noted it is working to ensure that Medicare Advantage plans negotiate in a manner that guarantees patient choice and offers patient protections with guardrails, including that step therapy can only be applied to new prescriptions for individuals who are not actively receiving a particular medicine. U.S. Department of Health and Human Services Secretary Alex Azar said, "As soon as next year, drug prices can start coming down for many of the 20 million seniors on Medicare Advantage, with more than half of the savings going to patients. Consumers will always retain the power to choose the plan that works for them: If they don't like their plan, they don't have to keep it. We look forward to seeing the results of tougher negotiation within Medicare, and expanding successful negotiation tools throughout our programs."