What providers need to know about the Inflation Reduction Act

The Inflation Reduction Act (IRA) became law on August 16, 2022 and includes several provisions to lower prescription drug costs for people with Medicare and reduce drug spending by the federal government.

Changes to Part D program

Effective January 1, 2023, all Medicare MAPD and Part D prescription drug plans are required to have a $35 cost share cap for covered Part D insulin products.

Effective January 1, 2023, all Medicare Part D plans are required to offer covered Part D adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP)* at a $0 cost share with no deductible.

Part B Rebatable Drugs

As of April 1, 2023, CarePlus members may pay less for certain drugs covered by Medicare Part B, based on a new and lower “coinsurance” amount.

Part B-Covered Insulin Savings

Beginning July 1, 2023, members will pay no more than $35 for a 1-month (30-day) supply of Part B-covered insulin. This cost limit applies to insulin dispensed through a pump or Medicare-covered durable medical equipment.