Over 200 Organizations Urge CMS to Withdraw Proposed New Medicare Part D Regulations

Patient, Healthcare, Employer Groups Say Proposed Rules Will “Severely Impede Beneficiaries’ Access to Affordable Health Plans and Medicines.”

WASHINGTON — More than 200 organizations representing millions of patients, seniors, employers and Americans with disabilities as well as multiple healthcare sectors are urging the Centers for Medicare and Medicaid Services (CMS) to withdraw proposed regulations that will significantly change the Medicare Part D prescription drug program in ways that will “have unintended consequences for seniors and beneficiaries with disabilities.”

In a letter to CMS Administrator Marilyn Tavenner, the organizations wrote, “We are deeply concerned that the proposed rule is inconsistent with the spirit and purpose of Medicare Part D, represents unnecessary changes to programs that are already extraordinary effective in containing costs and, most importantly, will severely impede beneficiaries’ access to affordable health plans and medicines.”

Mary R. Grealy, president of the Healthcare Leadership Council, one of the organizations signing the letter, said, “These regulations are an ill-advised solution in search of a problem.  Medicare Part D is improving the physical and financial health of beneficiaries by making prescription medications affordable.  These rules would fundamentally change a Part D program structure that is serving Medicare beneficiaries and taxpayers extremely well.”

In the letter, the groups cite four overarching issues with the proposed rules (while noting that there are other specific provisions that also raise concerns):

• The regulations would limit the number of Part D plans that could be offered to beneficiaries.  “Millions of seniors and beneficiaries with disabilities would lose their current plan of choice or face changes in coverage,” they wrote.

• Despite the clear intent of Congress that Medicare Part D should rely solely upon market-based pricing and private sector competition, the rules would “dramatically expand the federal government’s role in Medicare Part D despite the fact that there is no compelling reason for doing so.  Reshaping Part D in this way will neither improve quality and affordability, nor incentivize plan innovation,” the letter said.

• New cost burdens imposed as a result of the proposed regulations “will drive higher premiums for millions of beneficiaries and lead to higher costs for Medicare without tangible gains in service or quality for beneficiaries.”

• The timing of the proposed rule causes great uncertainty for Part D prescription drug plan sponsors, many of which are also involved in ensuring the success of Affordable Care Act health coverage exchanges.  “With the June bid submission deadline in mind, we urge you to withdraw the proposed rule in a timely manner to minimize disruption for beneficiaries when it comes time to make plan selections in October.”

In the letter, the organizations point out that the Medicare Part D program has maintained stable, affordable average premiums for beneficiaries, enjoys a 90 percent approval rating among seniors and has program costs that are more than 40 percent below original Congressional Budget Office projections.

“Medicare Part D has succeeded beyond expectations in enhancing the health and well-being of enrollees,” they wrote.  “Weakening these programs will result in a less healthy patient population and, consequently, increased Medicare costs in the long term.”