{"id":33022,"date":"2024-09-13T09:02:23","date_gmt":"2024-09-13T13:02:23","guid":{"rendered":"https:\/\/avalere.com\/?p=33022"},"modified":"2024-09-13T09:02:23","modified_gmt":"2024-09-13T13:02:23","slug":"navigating-the-medicare-prescription-payment-plan-what-it-means-for-stakeholders","status":"publish","type":"post","link":"https:\/\/advisory.avalerehealth.com\/insights\/navigating-the-medicare-prescription-payment-plan-what-it-means-for-stakeholders","title":{"rendered":"Navigating the Medicare Prescription Payment Plan: What It Means for Stakeholders"},"content":{"rendered":"<p>The Inflation Reduction Act\u2019s (IRA) Medicare Prescription Payment Plan (MPPP) will launch in January 2025, introducing a new way for Medicare Part D plan enrollees to manage their out-of-pocket (OOP) drug costs. This program, previously known as \u201cOOP smoothing\u201d, will allow enrollees to spread their Part D OOP costs over monthly payments throughout the plan year, rather than paying the full amount upfront at the pharmacy.<\/p>\n<p>In July 2024, the Centers for Medicare and Medicaid Services <a href=\"https:\/\/www.cms.gov\/files\/document\/medicare-prescription-payment-plan-final-part-two-guidance.pdf\">finalized<\/a> the second of two guidance documents implementing the program for the 2025 plan year. The guidance details program parameters and requirements for Part D plans and pharmacies, such as required plan outreach to beneficiaries and notices that must be provided to Part D enrollees at the pharmacy counter.<\/p>\n<p>Beyond plans and pharmacies, it will be critical for beneficiaries, caregivers, and providers to understand which Part D enrollees are most likely to benefit from the MPPP and what it means for treatment options. Finally, manufacturers will also want to consider the impact of the MPPP and what it means for Part D enrollee educational efforts and any charitable programs they provide.<\/p>\n<h2>Navigating the Changing Part D Landscape<\/h2>\n<p>This Insight is the first in a series in which Avalere will explore how the MPPP will reshape the landscape for Part D stakeholders, including patients and patient groups, manufacturers, Part D plans, and pharmacies and other providers.<\/p>\n<p>For support in navigating the changing Medicare Part D landscape, <a href=\"https:\/\/pages.avalere.com\/Insights.html?_gl=1*1idyec3*_gcl_au*MTYzMTI4MDY2Ny4xNzIwNzA2Mzg2*_ga*MzIwNDE4MzE5LjE3MjI1MTcyODU.*_ga_1LKSE3H6ZT*MTcyMjUyMzI0MS4yMC4xLjE3MjI1MjMyNTMuNDguMC4w\">connect with us<\/a>.<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The Inflation Reduction Act\u2019s (IRA) Medicare Prescription Payment Plan (MPPP) will launch in January 2025, introducing a new way for Medicare Part D plan enrollees to manage their out-of-pocket (OOP) drug costs. This program, previously known as \u201cOOP smoothing\u201d, will allow enrollees to spread their Part D OOP costs over monthly payments throughout the plan&hellip;<\/p>\n","protected":false},"author":28,"featured_media":27615,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[3],"tags":[1001],"content-categories":[129],"class_list":["post-33022","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-insights","tag-ira","content-categories-drug-pricing","entry","has-media"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Navigating the Medicare Prescription Payment Plan: What It Means for Stakeholders | Avalere Health Advisory<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/advisory.avalerehealth.com\/insights\/navigating-the-medicare-prescription-payment-plan-what-it-means-for-stakeholders\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Navigating the Medicare Prescription Payment Plan: What It Means for Stakeholders | Avalere Health Advisory\" \/>\n<meta property=\"og:description\" content=\"The Inflation Reduction Act\u2019s (IRA) Medicare Prescription Payment Plan (MPPP) will launch in January 2025, introducing a new way for Medicare Part D plan enrollees to manage their out-of-pocket (OOP) drug costs. This program, previously known as \u201cOOP smoothing\u201d, will allow enrollees to spread their Part D OOP costs over monthly payments throughout the plan&hellip;\" \/>\n<meta property=\"og:url\" content=\"https:\/\/advisory.avalerehealth.com\/insights\/navigating-the-medicare-prescription-payment-plan-what-it-means-for-stakeholders\" \/>\n<meta property=\"og:site_name\" content=\"Avalere Health Advisory\" \/>\n<meta property=\"article:published_time\" content=\"2024-09-13T13:02:23+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/advisory.avalerehealth.com\/wp-content\/uploads\/2022\/10\/24304-1-JessicaCortez-400x600-1.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"600\" \/>\n\t<meta property=\"og:image:height\" content=\"400\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Leah Keller\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@avalerehealth\" \/>\n<meta name=\"twitter:site\" content=\"@avalerehealth\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Leah Keller\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Navigating the Medicare Prescription Payment Plan: What It Means for Stakeholders | Avalere Health Advisory","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/advisory.avalerehealth.com\/insights\/navigating-the-medicare-prescription-payment-plan-what-it-means-for-stakeholders","og_locale":"en_US","og_type":"article","og_title":"Navigating the Medicare Prescription Payment Plan: What It Means for Stakeholders | Avalere Health Advisory","og_description":"The Inflation Reduction Act\u2019s (IRA) Medicare Prescription Payment Plan (MPPP) will launch in January 2025, introducing a new way for Medicare Part D plan enrollees to manage their out-of-pocket (OOP) drug costs. This program, previously known as \u201cOOP smoothing\u201d, will allow enrollees to spread their Part D OOP costs over monthly payments throughout the plan&hellip;","og_url":"https:\/\/advisory.avalerehealth.com\/insights\/navigating-the-medicare-prescription-payment-plan-what-it-means-for-stakeholders","og_site_name":"Avalere Health Advisory","article_published_time":"2024-09-13T13:02:23+00:00","og_image":[{"width":600,"height":400,"url":"https:\/\/advisory.avalerehealth.com\/wp-content\/uploads\/2022\/10\/24304-1-JessicaCortez-400x600-1.jpg","type":"image\/jpeg"}],"author":"Leah Keller","twitter_card":"summary_large_image","twitter_creator":"@avalerehealth","twitter_site":"@avalerehealth","twitter_misc":{"Written by":"Leah Keller","Est. reading time":"2 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/advisory.avalerehealth.com\/insights\/navigating-the-medicare-prescription-payment-plan-what-it-means-for-stakeholders#article","isPartOf":{"@id":"https:\/\/advisory.avalerehealth.com\/insights\/navigating-the-medicare-prescription-payment-plan-what-it-means-for-stakeholders"},"author":{"name":"Leah Keller","@id":"https:\/\/advisory.avalerehealth.com\/#\/schema\/person\/fb195190cdd6a0c7c2cc890515dd95f4"},"headline":"Navigating the Medicare Prescription Payment Plan: What It Means for Stakeholders","datePublished":"2024-09-13T13:02:23+00:00","dateModified":"2024-09-13T13:02:23+00:00","mainEntityOfPage":{"@id":"https:\/\/advisory.avalerehealth.com\/insights\/navigating-the-medicare-prescription-payment-plan-what-it-means-for-stakeholders"},"wordCount":254,"commentCount":0,"publisher":{"@id":"https:\/\/advisory.avalerehealth.com\/#organization"},"image":{"@id":"https:\/\/advisory.avalerehealth.com\/insights\/navigating-the-medicare-prescription-payment-plan-what-it-means-for-stakeholders#primaryimage"},"thumbnailUrl":"https:\/\/advisory.avalerehealth.com\/wp-content\/uploads\/2022\/10\/24304-1-JessicaCortez-400x600-1.jpg","keywords":["ira"],"articleSection":["Insights &amp; 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Prior to joining Avalere, Leah conducted policy research and analysis on federal healthcare issues such as Medicaid coverage and payment, commercial insurance coverage and access, healthcare reform, and ACA implementation at the Guttmacher Institute, a thinktank focused on advancing reproductive health and rights. Prior, Leah coordinated data collection, analysis, and publications for George Washington University\u2019s Center for Social Well-Being and Development. Leah holds an MPH in maternal and child health from George Washington University and a BA in anthropology from St. Mary\u2019s College of Maryland.","url":"https:\/\/advisory.avalerehealth.com\/author\/lkelleravalere-com"}]}},"_links":{"self":[{"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/posts\/33022","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/users\/28"}],"replies":[{"embeddable":true,"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/comments?post=33022"}],"version-history":[{"count":2,"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/posts\/33022\/revisions"}],"predecessor-version":[{"id":33024,"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/posts\/33022\/revisions\/33024"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/media\/27615"}],"wp:attachment":[{"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/media?parent=33022"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/categories?post=33022"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/tags?post=33022"},{"taxonomy":"content-categories","embeddable":true,"href":"https:\/\/advisory.avalerehealth.com\/wp-json\/wp\/v2\/content-categories?post=33022"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}