Messing with Success: How CMS’ Attack on the Part D Program Will Increase Costs and Reduce Choices for Seniors

Joe Baker, President of the Medicare Rights Center, testifies today before the Subcommittee on Health of the U.S. House Committee on Energy and Commerce regarding recent changes to the Medicare Advantage and the Part D prescription drug program proposed by the Centers for Medicare & Medicaid Services (CMS).

In the testimony, Baker recognizes the strides that CMS seeks to make in the areas of oversight, monitoring and transparency. He also emphasizes that each of the proposed policies reflected in the rule should be evaluated on their own merits—as opposed to supporting or opposing the proposed rule as a whole.

The provisions of the rule that the Medicare Rights Center supports include those that would:

  • Ensure meaningful differences between Part D plans
  • Increase drug pricing transparency, fairness, and accuracy
  • Enhance Medicare Advantage and Part D plan oversight
  • Improve beneficiary notices detailing  plan changes

Baker’s testimony also expresses opposition to CMS’ proposed policy to scale back the protected drug classes in Medicare Part D, which would end open formulary access for the antidepressant, antipsychotic and immunosuppressant drug classes. The testimony asserts that CMS’ reliance on existing beneficiary protections, including the Part D appeals process, to preserve access to drugs that lose protected status is misplaced.

CMS also points to drug prices as a primary reason for scaling back the protected drug classes. Baker recognizes that these concerns are valid, but that CMS should not pursue policies that unduly restrict access in order to address the problem.

Read Testimony