Alliance, 61 Organizations Provide Feedback on Patient-Centered Implementation of Medicare Prescription Payment Plan

Last month, CMS released guidance on the Medicare Prescription Payment Plan (MP3). The MP3 has previously been known as Medicare Part D “cost smoothing” or the maximum monthly caps program. In the guidance, CMS proposes implementation parameters for the program and poses several questions for additional feedback from stakeholders. Part 2 of the guidance, with a greater focus on education efforts around the MP3, is expected in Spring 2024.

The MP3 will provide an important, optional flexibility to Medicare beneficiaries to pay their out-of-pocket expenses for prescription drugs through zero-interest payment installments. However, significant work remains to ensure beneficiaries are able to activate the flexibility when they need to do so, and to educate the public about the availability of the MP3 starting in 2025 and how to enroll.

The letter, endorsed by 62 organizations, encourages CMS to:

• Finalize and incorporate patient protections proposed by the agency, including a payment grace period, reinstatement process for beneficiaries, and appeals process;
• Engage beneficiaries & multiple stakeholder groups, including care providers, in education efforts;
• Enable point of sale opt in during the first year (2025) of the program rather than waiting until future years;
• Err on the side of notifying more rather than fewer beneficiaries they are “likely to benefit” by opting into the program;  
• Explore flexibilities to streamline potential first month beneficiary liability; and
• Provide multiple payment modalities, including autopayment options, for MP3 participants.

Read the full letter.

For more information on the Alliance’s efforts to reduce out-of-pocket costs for prescription drugs, visit www.loweroutofpocketcosts.org.