CMS Shelves Controversial Part D Proposals


The Centers for Medicare & Medicaid Services (CMS) will not finalize at this time several controversial changes to the popular Medicare Part D program that were included in a recent proposed rule, according to a March 10 letter from CMS Administrator Marilyn Tavenner.

The letter, which was addressed to House Ways and Means Committee Ranking Member Sander Levin (D-MI), indicated CMS is shelving proposals to lift the protected class definition on three drug classes (antidepressants, immunosuppressants, and antipsychotics); to require Part D sponsors to contract with any retail pharmacy willing to accept lower negotiated drug prices; to reduce the number of Part D plans a sponsor may offer in a given area; and to clarify non-interference provisions.

Tavenner said in the letter that CMS will finalize proposals related to consumer protections, antifraud provisions, and transparency, including broadening the release of privacy-protected Part D data.

CMS has faced intense opposition from lawmakers, both Republicans and Democrats, and stakeholders since it issued in January (79 Fed. Reg. 1918) the proposed rule, which also includes proposals affecting the Medicare Advantage program.

In the letter, Tavenner cited “the complexities of these issues and stakeholder input” as the reasons for not finalizing the controversial proposals.

“We will engage in further stakeholder input before advancing some or all of the changes in these areas in future years,” she said.

In a statement, Levin called on House Republicans to withdraw a bill that would prohibit CMS from implementing any part of the proposed rule in light of CMS’ announcement. Levin said the legislation “would undermine clearly helpful beneficiary and anti-fraud protections and would be gross overreach, undermining the regulatory process.”

Ways and Means Committee Chairman Dave Camp (R-MI) said “while this announcement provides limited relief in the short-term, it should lay the groundwork for strong bipartisan support for legislation expressing Congress’ disapproval of these proposals. As Part D approaches a decade of providing access to affordable prescriptions for seniors, Congress must redouble its efforts to work with all parties to ensure the long-term viability of the successful Part D program.”


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