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Sharing a CMS memo sent to Plans on IRA Changes to Cost Sharing for Part B Drugs for Contract Year 2023

 

Ann Kayrish

Senior Program Manager for Medicare

National Council on Aging

251 18th Street South

Suite 500

Arlington, VA 22202

571-527-3945

 

From: Simpson, Melissa (ACL) <xxxxxx@ACL.HHS.GOV>
Sent: Thursday, November 10, 2022 8:53 AM
To: xxxxxx@LIST.NIH.GOV
Subject: CMS: Inflation Reduction Act Changes to Cost Sharing for Part B Drugs for Contract Year 2023 Medicare Advantage and Section 1876 Cost Plans

 

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This memorandum provides Medicare Advantage organizations and Section 1876 Cost Plan sponsors with guidance on the beneficiary cost sharing protections under section 11101 (Part B drugs with prices increasing faster than inflation) and section 11407 (Monthly cost-sharing cap for insulin furnished under Part B benefit) of the Inflation Reduction Act (IRA, P.L. 117-169), enacted on August 16, 2022. 

The memorandum provides plan instructions and notes limited time to implement to coinsurance adjustment thus allowing for refunds to enrollees in 2023 only. Additional guidance for dually eligible individuals and the process to confirm a refund is due or paid are forthcoming.

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