CMS payment model targets lower insulin costs for Part D beneficiaries

Medicare Part D plans and drug makers may apply to participate in a new payment model starting in January, which will allow plan sponsors to offer benefits that limit cost sharing for a 30-day supply of insulin to no more than $35. To encourage participation, the model will give qualifying plans that enroll a high number of insulin-dependent patients the option of additional risk corridor protection for calendar years 2021 and 2022. The model also will test how to encourage healthy behaviors and medication adherence through Part D reward and incentive programs. To participate, drug makers may apply through March 18 and Part D sponsors through May 1. CMS plans to make a list of participating drug makers available to Part D sponsors on or around March 20.