CMS issues additional guidance on program to allow people with Medicare to pay out-of-pocket prescription drug costs in monthly payments

Feb. 20, 2024
The Inflation Reduction Act’s Medicare Prescription Payment Plan will allow people to pay Medicare Part D out-of-pocket costs over the course of the year starting in 2025.

The Centers for Medicare & Medicaid Services (CMS) released the second part of draft guidance for the Medicare Prescription Payment Plan that outlines requirements for Medicare Part D plan sponsors, including outreach and education requirements, pharmacy processes, and operational considerations, for the program’s first year, 2025.

The draft guidance is part of the Inflation Reduction Act, which will help reduce the burden of high upfront out-of-pocket prescription drug costs for seniors and people with disabilities with Medicare prescription drug coverage by allowing them to spread out costs over the year rather than requiring they pay in one lump sum.

The draft guidance provides information on outreach, education, and communications requirements to ensure that people with Medicare Part D, particularly those who are most likely to benefit from this program, are aware of the Medicare Prescription Payment Plan.

CMS is seeking comments from the public on the draft part two guidance. The comment period is open for 30 days. Comments received by March 16, 2024 will be considered during development of the final guidance. Comments should be sent to [email protected] with the following subject line: “Medicare Prescription Payment Plan Guidance – Part Two.”

The draft part two guidance builds on the previously released draft part one guidance - PDF and fact sheet - PDF (released on August 21, 2023). Final part one guidance is forthcoming.

For the draft part two guidance, please visit: - PDF

For the fact sheet on the draft part two guidance, please visit: - PDF

For an implementation timeline for the Medicare Prescription Payment Plan, please visit: - PDF

HHS release