Inflation rebates to cut down Medicare cost for 41 Part B drugs

TL/DR –

Medicare will reduce the coinsurance amount for 41 Part B prescription drugs from 20% to between 3.8% and 19.9% from April to June, under the Inflation Reduction Act. This change is due to the requirement of the IRA that drug companies must pay rebates to Medicare when the prices for certain prescription drugs increase faster than inflation. The list of drugs affected by this coinsurance adjustment may change every quarter.

Medicare Cuts Coinsurance for 41 Part B Drugs under Inflation Reduction Act

From April through June, the Inflation Reduction Act (IRA) will prompt Medicare to lower coinsurance for 41 Part B prescription drugs. The Centers for Medicare & Medicaid Services (CMS) announced that reductions will range from 20% to between 3.8% and 19.9%, depending on the drug.

Under this Act, health care providers will receive payment from Medicare to bridge the gap between the Medicare allowed amount and the modified beneficiary coinsurance, once the Part B deductible has been applied and before sequestration, if necessary.

According to the IRA, if prices for specific single-source and biosimilar prescription drugs covered under Part B exceed inflation rates, drug companies must pay rebates to Medicare. The list of Part B drugs affected by a coinsurance adjustment may fluctuate quarterly. Detailed information is available on the CMS fact sheet.

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