Medicare Drug Plan Changes Risk Complicating Treatment Access

Patient organizations and charitable groups are urging the Biden administration to take additional steps to contain a potential uptick in utilization management tactics by Medicare prescription drug plans next year.

Consumer-friendly provisions of the Inflation Reduction Act that take effect in 2025 will cut out-of-pocket drug spending for Medicare beneficiaries, but increase costs and coverage liability for Part D drug plans. To help with the transition, the Department of Health and Human Services will provide more upfront funding to the plans and launch a demonstration program designed to stabilize premiums and help stand-alone drug plans weather possible losses.

But it’s ...