A final rule by the U.S. Department of Health and Human Services (HHS) and an interim final rule by the Centers for Medicare and Medicaid Services (CMS) that focus on drug costs in Medicare Part B and Part D were recently published.
While the rules were released as final and interim final, respectively, the road ahead is uncertain. It appears likely the rules will face legal challenges prior to or after the effective dates of their provisions. It is difficult to predict whether the policies finalized in these rules will reduce the total cost of drugs for the government and Medicare beneficiaries as intended.
Milliman professionals explore the two rules and explain their implications for Medicare drug pricing in this article.