Impact of the Inflation Reduction Act on Patient Healthcare in the United States

Introduction

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Manatt, Phelps & Phillips LLP

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As part of IRA implementation and in advance of calendar year 2025, which is when the implementation of Part D redesign changes accelerate, CMS could take steps to protect beneficiaries by preserving access…

United States
Food, Drugs, Healthcare, Life Sciences

Protecting Beneficiaries

Under the impending changes to Part D, beneficiaries face risks due to plan sponsors’ changing incentives. CMS has issued warnings to PDP sponsors regarding drug placement on non-preferred formulary tiers without clinical justification. However, more actions can be taken by CMS within its legal authority.

Measures Taken and Future Steps

This paper delves into the upcoming changes in Part D, the risks posed to beneficiaries, initial protective measures by CMS, and potential steps that could enhance beneficiary access to therapy under current legal provisions.

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