Protecting Innovation to Rare Cancers (PIRC) Coalition Asks CMS For Several Refinements to Proposed Implementation Details of the Medicare Prescription Payment Plan Program

The PIRC Coalition appreciates several patient-friendly details Centers for Medicaid and Medicare Services (CMS) proposed to implement the Medicare Prescription Payment Plan program.  Previously known as the “smoothing” provisions of the Inflation Reduction Act (IRA), the program is intended to help Medicare patients spread the cost of their prescriptions over a plan year.  

However, PIRC members highlighted several areas where CMS could still improve upon the program, including:

  • An interactive ‘calculator’ to help patients calculate their monthly costs.
  • A process to allow patients to sign up for the program at the pharmacy (e.g., point-of-sale or POS), rather than directly with the Part D plan.
  • Greater clarity on out-of-pocket (OOP) obligations in specific scenarios like returns (e.g., due to side effects, etc.)
  • Uniformity of forms, notices, etc., options for participating in the new program through an 800#, paper as well as electronic means, and simplicity of instructions and communications.

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