Medicare Moves on 2011 Reform Action Giving 50% Drug
Discount to Seniors in Donut Hole
Agreements with drug manufacturers represents an
unprecedented partnership to help millions of Medicare beneficiaries
May 25, 2010 - The Centers for Medicare & Medicaid
Services (CMS) has issued new guidance to Part D plan sponsors to
guarantee that senior citizens and other Medicare beneficiaries enrolled
in Part D prescription drug plans will see 50 percent savings on their
brand name and some authorized generic drugs when they enter the
coverage gap, or donut hole, 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. These agreements with manufacturers represent an
unprecedented partnership to help millions of Medicare beneficiaries.
Discounts will apply when the beneficiary reaches the coverage gap.
Eligible beneficiaries will see the discount when they buy their drugs
at their local pharmacy counter.
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 released today. As
part of the June 1 meeting, CMS is encouraging drug manufacturers, Part
D plan sponsors, and representatives from the beneficiary advocacy
community to provide input and comments.
Closing the coverage gap is an important part of
the Patient Protection and Affordable Care Act of 2010, (the Affordable
Care Act) signed by President Obama earlier this year, beginning with a
one-time check for $250 in 2010 for those that reach the donut hole in
2010 and are not eligible for low-income assistance, the 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 today facilitate
the implementation of the Affordable Care Acts 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.
The Part D plan guidance released today was
finalized after receiving comments on the draft guidance that was issued
on April 30. This guidance 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.
May 25, 2010 - The Centers for Medicare & Medicaid
Services (CMS) has issued new guidance to Part D plan sponsors to
guarantee that senior citizens and other Medicare beneficiaries enrolled
in Part D prescription drug plans will see 50 percent savings on their
brand name and some authorized generic drugs when they enter the
coverage gap, or donut hole, during 2011. 
