Stephnie John on Medicare Part D

CMS’s 2026 Final Medicare Advantage Rule Focuses on Implementing the IRA and Deregulation

In April, CMS finalized its Contract Year (CY) 2026 Medicare Advantage and Part D Final Rule (Final Rule). With CMS releasing the 2026 Medicare Advantage and Part D Proposed Rule in December under the Biden Administration,...more

5/9/2025 / Biden Administration , Centers for Medicare & Medicaid Services (CMS) , Final Rules , Inflation Reduction Act (IRA) , Medicare Advantage , Medicare Part D , Prescription Drugs , Proposed Rules , Regulatory Reform , Trump Administration

Mintz IRA Update — The IRA in 2025: The Future of Medicare Part D

Last year was a pivotal year for the pharmaceutical industry. Under the IRA’s Medicare Drug Price Negotiation Program (the Negotiation Program), the US government negotiated the prices of 10 selected high-expenditure,...more

2/14/2025 / Centers for Medicare & Medicaid Services (CMS) , Health Insurance , Healthcare Reform , Inflation Reduction Act (IRA) , Medicare , Medicare Part D , Pharmaceutical Industry , Prescription Drugs

Mintz IRA Update — Fourth Edition: Q1 2025

Mintz’s Pharmacy Benefits and PBM Contracting Practice is pleased to present the ‘Fourth Edition: Q1 2025’ of our Mintz IRA Update, a regular publication that delves into developments of the Inflation Reduction Act of 2022...more

2/14/2025 / Drug Pricing , Inflation Reduction Act (IRA) , Medicare , Medicare Part D , Pharmaceutical Industry , Pharmacy Benefit Manager (PBM) , Prescription Drugs , Regulatory Agenda , Regulatory Requirements , Supply Chain

Mintz IRA Update — The Consequences and Costs of Redesigning the Part D Program

The passage of the Inflation Reduction Act of 2022 (IRA) marked a significant milestone in Congress’s ongoing efforts to address escalating health care costs. While the IRA aims to rein in government spending on Medicare and...more

7/16/2024 / Beneficiaries , Centers for Medicare & Medicaid Services (CMS) , Drug Pricing , Health Insurance , Health Plan Sponsors , Inflation Reduction Act (IRA) , Manufacturers , Medicare Part D , Out-of-Pocket Expenses , Reimbursements

Mintz IRA Update — The IRA in 2024: The Medicare Drug Price Negotiation Program in Full Swing and Other Developments

Our team’s preparation for the year includes a review of the anticipated impact of the IRA on the health care industry in 2024. Many of the IRA’s key provisions that go into effect this year are centered around two main...more

3/18/2024 / Centers for Medicare & Medicaid Services (CMS) , Drug Pricing , Healthcare , Inflation Reduction Act (IRA) , Medicare , Medicare Part D , Negotiations , Prescription Drugs

Senate Democrats Pass Long-Awaited Drug Pricing Reforms in Budget Reconciliation Bill

On August 7, 2022, after extensive deliberation, Senate Democrats passed their long-awaited reconciliation bill, the Inflation Reduction Act of 2022 (the Reconciliation Bill). In addition to climate and tax provisions, the...more

8/10/2022 / Anti-Kickback Statute , Biosimilars , Budget Reconciliation , Drug Pricing , Medicare , Medicare Part D , Out-of-Pocket Expenses , Pharmacy Benefit Manager (PBM) , Price Inflation , Transparency

Medicaid Best Price 101: A Review of Medicaid Best Price Policy and New CMS Guidance on Medicaid Best Price Reporting for Value...

At the end of March 2022, the Centers for Medicare & Medicaid Services (CMS) released guidance to drug manufacturers and states on reporting Medicaid Best Price under value based purchasing (VBP) arrangements (Medicaid Best...more

4/27/2022 / Centers for Medicare & Medicaid Services (CMS) , Department of Veterans Affairs , Final Rules , Medicaid , Medicaid Drug Rebate Program , Medicare Coverage Gap Discount Program , Medicare Part D , New Guidance , Section 340B , Value-Based Purchasing

Stephnie John

Mintz

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