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Thursday, November 7, 2024

Representatives introduce bipartisan act increasing medication access options under medicare

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U.S. Rep. Thomas Kean Jr., District 7 | Official U.S. House headshot

U.S. Rep. Thomas Kean Jr., District 7 | Official U.S. House headshot

(June 14, 2024) WASHINGTON, DC – Yesterday, Representatives Tom Kean, Jr. (NJ-07), Yadira Caraveo (CO-08), and Jen Kiggans (VA-02) introduced the Increasing Medication Access for Seniors Act. The bipartisan legislation aims to increase awareness and outreach of Medicare beneficiaries’ ability to spread prescription drug costs over the course of a year.

Effective January 1, 2025, Medicare beneficiaries will have the option to "smooth" their Part D out-of-pocket costs through the Medicare Prescription Payment Plan. This program will help beneficiaries who face high cost sharing for prescription drugs manage these costs by spreading them out over the course of the plan year. Medicare drug costs will be capped at $2,000 for all Medicare beneficiaries, but patients will not benefit from "smoothing" unless they sign up for it. Starting with plan year 2025, any Part D enrollee may opt into the program prior to the beginning of a plan year or in any month during a plan year.

“Obtaining medication through Medicare should not be difficult,” said Congressman Kean. “This bill will help facilitate easier access to prescription medications, creating more transparency for New Jerseyans in my district and nationwide. I am honored to co-lead the Increasing Medication Access for Seniors Act with Representatives Caraveo and Kiggans.”

“As a doctor, I have seen firsthand that high prescription drug costs have deterred seniors in our community from getting the prescription medications that they need,” said Congresswoman Caraveo. “The Medicare Prescription Payment Plan will offer beneficiaries the option to pay their out-of-pocket costs in monthly payments instead of all at once. I am proud to introduce this legislation to help seniors more easily afford their medications.”

“As a geriatric nurse practitioner who has had the privilege of caring for members of our Greatest Generation, I know how critical it is for our seniors to have access to the medications they need,” said Congresswoman Kiggans. “I am proud to help introduce this bipartisan legislation to improve Medicare benefits and help make access to life-saving medications more affordable for our seniors.”

“We are grateful to Representative Caraveo, Representative Kiggans, and Representative Kean for working tirelessly to ensure that older adults and people with disabilities can benefit from the Medicare Prescription Payment Plan,” said Michael Ward, Vice President of Public Policy and Government Relations at the Alliance for Aging Research. “Starting January 1, 2025, the option to pay out-of-pocket Part D costs through interest-free payment installments has the potential to help millions of beneficiaries better afford their prescription medications. However, few will benefit unless CMS conducts robust education and streamlines patient enrollment processes so beneficiaries can easily sign up for the benefit. Enacting this bill will provide critical insights to help ensure that these efforts are successful.”

The Increasing Medication Access for Seniors Act would direct the Centers for Medicare and Medicaid Services (CMS) to report specific information back to Congress:

- The number of beneficiaries who have taken up the smoothing option and those categorized as "likely to benefit" by CMS.

- Information on methods CMS is using to encourage participation such as via Medicare.gov, Medicare and You handbook, 1-800-MEDICARE hotline, and provider-focused communications like those from Medicare Learning Network.

- Additional outreach efforts conducted by CMS with other stakeholders including provider associations and societies; patient and consumer advocacy groups; pharmacy benefit managers; pharmacies; and health insurance providers.

The Increasing Medication Access for Seniors Act is endorsed by several organizations including Alliance for Aging Research, Global Liver Institute, Lupus Foundation of America, RetireSafe among others.

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