US Medicare To Codify Inflation Rebates, Adds Reconciliation Process

The US Medicare agency is creating a formal reconciliation process for new inflation rebates in Part B and Part D of the program.

rebate
Going forward, Part B rebates will be invoiced quarterly, while Part D rebates will be invoiced annually. • Source: Shutterstock

The US Centers for Medicare and Medicaid Services is planning to create a formal reconciliation process for the Medicare Part B and Part D inflation rebate programs, the agency said in a proposed regulatory codification of the new rebates created via the 2022 Inflation Reduction Act.

Key Takeaways
  • A formal reconciliation process will be created for Medicare Parts B and D inflation rebates.

CMS is proposing the inflation rebate policies in the annual update rule to the Part B Physician Fee Schedule. The...

Read the full article – start your free trial today!

Join thousands of industry professionals who rely on Pink Sheet for daily insights

  • Start your 7-day free trial
  • Explore trusted news, analysis, and insights
  • Access comprehensive global coverage
  • Enjoy instant access – no credit card required

More from Medicare

Merck’s Keytruda Gains Medicare Negotiation Reprieve With Expanded Orphan Exemption

 
• By 

Bristol Myers Squibb’s Opdivo and Merck's Welireg also could benefit from the delay in Medicare price negotiation process eligibility.

340B Transparency: CMS Proposes Claims Repository For Medicare Part D Drugs

 
• By 

The plan was announced as the White House Office of Management and Budget discusses with stakeholders a widely anticipated guidance about the 340B rebate model, which is being advanced by manufacturers to enhance transparency and control ballooning discounts in the program.

33 States Agree To Standardized Access Policies In Medicaid Sickle Cell Payment Demo

 

States also agreed to fund patient travel to specialized treatment centers as part of their participation in the Medicaid demo of CMS-negotiated outcomes-based contracts for Vertex/CRISPR's Casgevy and bluebird bio's Lyfgenia.

Part B Negotiation Proposal Would Lower Prices In MA, Private Plans Too, Stakeholders Complain

 
• By 

The issue is attracting more attention as the 2028 deadline for implementing Medicare negotiated prices for Part B drugs approaches.

More from Government Payers

Part B Negotiation Proposal Would Lower Prices In MA, Private Plans Too, Stakeholders Complain

 
• By 

The issue is attracting more attention as the 2028 deadline for implementing Medicare negotiated prices for Part B drugs approaches.

China Unveils Multiple Policies To Support Innovative Drugs Throughout Life Cycle

 
• By 

China has announced a raft of new measures to encourage innovative drug development across the product life cycle, including using insurance data to differentiate new therapies and applying commercial insurance to selected novel products.

Medicaid Changes Could Have Major Impact on Recent Coverage Improvements

 
• By 

Insurance trade groups warned that the Big Beautiful Bill destabilize Medicaid and result in the largest ever roll-back in health care coverage in the US.