PAN advocates for patient-centered implementation of Medicare Prescription Payment Plan
The Medicare Part D program will see major changes in 2025, when a key reform enacted through the Inflation Reduction Act takes effect. The Medicare Prescription Payment Plan, formerly known as smoothing, will offer the opportunity for people with Part D plans to voluntarily enroll in a program that allows them to spread out-of-pocket costs for prescription medications throughout the year. Coupled with the upcoming Part D annual cap of $2,000, this reform will significantly improve the affordability of prescription medications.
The PAN Foundation was a pioneering voice behind smoothing, and with the passage of the Inflation Reduction Act, we have continued to advocate for patient friendly implementation of the program. Throughout the last year, PAN has shared feedback with the Centers for Medicare & Medicaid Services (CMS) through a series of meetings, keeping a consistent message about prioritizing patient protections and education.
Recently, CMS provided new guidance about how education and outreach will be carried out for the Medicare Prescription Payment Plan. PAN shared recommendations and comments on the guidance with CMS, joining other leading patient advocacy and healthcare provider organizations in commenting on the guidance as well.
Our key recommendations include:
- Encouraging CMS to put strategies in place to educate all people enrolled in Medicare Part D plans about the Medicare Prescription Payment Plan. While targeted outreach to those “likely to benefit” is important, a broader approach to education is equally important.
- Consistently combining education about the Medicare Prescription Payment Plan with education about the Part D $2,000 annual cap.
- Highlighting opportunities to enroll in Medicare’s Extra Help Program. For those with low-income who may qualify, this program may be a better option than the Medicare Prescription Payment Plan.
- Offering an option to enroll in the Medicare Prescription Payment Plan at the point of sale (e.g., pharmacy counter), a move that may increase the number of individuals who enroll and can benefit from the program.
- Requiring Part D sponsors to include information on their websites about patient protections, appeals processes, and reinstatement criteria to ensure that enrollees are aware of their rights and recourse options under the program.
- Asking CMS to ensure that educational materials provided by Part D plans are created with easy-to-understand language for patients, in multiple languages. Using standardized language for the Medicare Prescription Payment Plan (and relevant acronyms and abbreviations) across promotional materials will help to limit confusion among patients and ensure consistency in messaging.
Read our entire list of recommendations in our letters to CMS:
PAN joins MAPRx Coalition commenting on the implementation of the Medicare Prescription Payment Plan
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