Alliance Applauds Inclusion of Patient Protections in Medicare Payment Installment Plan

The Centers for Medicare and Medicaid Services (CMS) released proposed guidance on the Medicare Prescription Payment Plan (MPPP) on August 21. The MPPP will allow Medicare Part D beneficiaries the option to pay out-of-pocket costs for prescription drugs in monthly installment payments starting in 2025. The CMS proposed guidance on the MPPP – previously referred to as “maximum monthly caps” or “cost smoothing” – outlines implementation parameters for the new program. CMS is accepting public comment on the proposed guidance until September 20.

The Alliance led advocacy efforts urging CMS to include several beneficiary protections, some of which made it into the draft guidance, including: a grace period for late payments, an appeals process if a beneficiary is disqualified from or is denied from enrolling in the program, and the ability for beneficiaries to restore eligibility at the point-of-sale once overdue balances are paid. The draft guidance indicates that point-of-sale enrollment may not be available when the MPPP becomes available in 2025, though the agency is considering ways to allow beneficiaries to enroll “at the pharmacy counter” in future years.

“The Alliance for Aging Research thanks CMS for their responsiveness to patient advocacy organizations in the implementation of the Medicare Prescription Payment Plan,” said Michael Ward, the Alliance’s Vice President of Public Policy and Government Relations. “It is essential that no beneficiary walks away from the pharmacy counter due to affordability issues and we will continue to work with CMS to ensure that beneficiaries can enroll when access to the MPPP is most needed.”

For additional information, read CMS’s announcement and fact sheet. To submit a comment, email [email protected] by September 20.

If you are a member of the media and want to learn more or interview Alliance staff on this issue, email Katie Riley, Vice President of Communications, at [email protected].