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Trump’s Executive Order Limiting Medicare Drug Payments Faces Hurdles

 
• By Brenda Sandburg

Under test payment model, Medicare would pay no more than most-favored-nation price for Part B and Part D drugs, but how and when the model program would be implemented remains unclear. BIO may pursue legal action as questions on how plan would be implemented and if the administration will provide notice and comment period for stakeholder input remain.

Many pills and tablets on dollar bill and decrease graph
President Trump issues executive order limiting Medicare drug payments to most-favored-nation price • Source: Shutterstock

President Trump issued an executive order to limit the amount Medicare pays for Part B and Part D prescription drugs and biologics to the “most-favored-nation” price but it is uncertain what an implementing rule would consist of and when the model payment plans would be implemented.

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More from Medicare

Medicare Price Negotiation: Trump Order Adds Momentum To ‘Pill Penalty’ Fix

 
• By Cathy Kelly

Wide-ranging executive order to lower drug prices also hints at changes in upcoming guidance on the Medicare price negotiation program but few other potentially impactful near-term actions.

GLP-1 Drug Coverage Growing For Obesity In Medicaid, But Only For Diabetes In Medicare

 
• By Cathy Kelly

Coverage data from the two programs suggest Medicare beneficiaries may be more disappointed than Medicaid enrollees by the Trump Administration’s decision not to mandate the programs cover obesity drugs.

New Medicare Negotiation Program ‘Iterations’ Inevitable, Former CMS Official Blum Says

 
• By Cathy Kelly

Jonathan Blum, who was principal deputy administrator during the Biden Administration, explained the agency’s approach to setting up the price negotiation program and said changes likely will be implemented by the Trump Administration.

Dr. Oz Takes Over CMS Amid Major Transformation Of Medicare Part D

 
• By Cathy Kelly

As CMS administrator, Mehmet Oz will oversee the second cycle of Medicare drug price negotiations and Part D redesign issues, but will have experienced deputies to help.

More from Government Payers

Dr. Oz Takes Over CMS Amid Major Transformation Of Medicare Part D

 
• By Cathy Kelly

As CMS administrator, Mehmet Oz will oversee the second cycle of Medicare drug price negotiations and Part D redesign issues, but will have experienced deputies to help.

Dramatic HHS Layoffs A Response To ‘Existential Crisis,’ Kennedy Advisor Argues

 
• By Cathy Kelly

Calley Means defended reductions in force at the Health and Human Services Department that shocked and outraged federal workers and stakeholders.

Newest HHS Staff Cuts Could Stymie CMS Health Plan Oversight

 
• By Leslie Small

A former CMS manager worries casework and other necessary functions could suffer as a result of the 300 staff cuts at the agency that are part of a massive HHS restructuring.