Medicare Part D Redesign Will Lead To Bigger Rebate Demands – MedPAC Panelist

DeRoyal’s DeBusk urges a focus on rebates, while Brookings' Ginsburg wants a focus on design, not savings per se, as MedPAC discusses restructuring the Part D design to better accommodate current market dynamics. Formal recommendations to Congress may be approved in the spring.

rebate - cube with letters, sign with wooden cubes

A redesign of the Medicare Part D benefit structure that increases financial obligations for plans in the catastrophic phase will lead to demands for significantly higher rebates from manufacturers to offset costs, Medicare Payment Advisory Commission member Brian DeBusk, CEO of DeRoyal Industries, predicted during a panel meeting on 16 January.

MedPAC is working on redesign recommendations to send to Congress that would cap beneficiary spending, decrease Medicare reinsurance in the catastrophic phase from 80% to 20% and increase plan liability in that phase from 15% to 60% for brands. It would also establish a new manufacturer discount requirement

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