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With Final Rule, Seniors Are Protected, But Threats to Part D Remain

In early February, the Centers for Medicare & Medicaid Services (CMS) released a final rule to make changes to Medicare Advantage and Part D. Among other things, the rule aimed to finalize remaining changes included in a proposed rule from January 2014 but that were not finalized last summer. Importantly, this final rule not only leaves out the harmful proposed changes that Medicare Today and hundreds of other organizations spoke out against last year, the rule actually listed some of the most controversial provisions that were purposefully left out.

As noted in CMS’ final rule summary:

“The rule does not finalize any of the following provisions: 

  • Lifting the protected class designation on three drug classes – antidepressants, antipsychotics and immunosuppressants for transplant rejection;
  • Requiring Medicare Part D sponsors to include any pharmacy willing to accept the terms and conditions to participate in narrower pharmacy networks that offer preferred cost sharing to beneficiaries;
  • Reducing the number of Part D plans a sponsor may offer; and
  • Codifying CMS interpretation of the Part D non-interference provision.”

This is a critical victory for seniors and would not have been possible without the collaboration and hard work of hundreds of organizations and individuals like you that opposed these changes, which would have undermined the Part D program and jeopardized seniors’ access to critical medications. We applaud the effort advocates have made since the very beginning of this debate to ensure seniors are heard and protected.

It is critical for seniors and advocates alike to remain vigilant against new, potentially harmful policy changes to Part D. As legislators and regulators continue to assess the program, we urge them to reach out to patient and health advocates to discuss any proposed changes, to ensure their efforts do not endanger a successful program that helps keep seniors healthy.

We are pleased that CMS has heeded the concerns of advocates, and we look forward to working together to continue to safeguard Part D against changes that would negatively impact access to affordable prescription drug coverage for seniors and disabled beneficiaries.