Comer Seeks Briefing on Biden Administration’s Medicare Part D Redesign Over Concerns of Higher Drug Prices and Reduced Access

WASHINGTON—Today, House Committee on Oversight and Government Reform Chairman James Comer (R-Ky.) is conducting oversight of the Medicare Part D program amid reports that Part D plans and Pharmacy Benefit Managers (PBMs) are restricting access to certain prescription drugs and pressuring manufacturers to raise rebates—and ultimately prices—to offset the costs imposed by the Biden Administration’s Inflation Reduction Act’s (IRA) Part D redesign. In a letter to the Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz, M.D., Chairman Comer is requesting a staff-level briefing on all efforts by CMS to prevent abuse in the Medicare Part D program and ensure Medicare recipients are not negatively impacted by the IRA Part D redesign.

“The Committee on Oversight and Government Reform is conducting oversight of the Medicare Part D Program. The Committee understands that Part D plans and Pharmacy Benefit Managers are limiting access to certain prescription drugs and forcing manufacturers to raise rebates, and therefore prices, to cover the costs of the Inflation Reduction Act (IRA) Part D redesign. We therefore request you provide a staff-level briefing on the Centers for Medicare and Medicaid Services’ (CMS) efforts to ensure Medicare recipients are not negatively impacted by the IRA Part D redesign. As you are aware, the IRA, under the guise of lowering health care costs, created the Part D Manufacturer Discount Program, or Part D redesign, which made drug manufacturers pay additional discounts on prescription drugs.  This Part D redesign also increased the liability for Part D plans and PBMs because it reduced the federal government’s direct spending,” wrote Chairman Comer.

“Apparently, as the redesign went into effect, Part D plans and PBMs used their position as middlemen to improperly pass the costs of the Part D redesign onto manufacturers.  According to reports, Part D plans and PBMs are incentivized by the Part D redesign to prefer higher list price drugs with higher rebates, a direct contradiction to the stated goals of the IRA. President Donald Trump consistently highlighted the importance of reducing the cost of prescription drugs for all Americans and it is vital that plans and PBMs are not pushing patients to higher cost medications to pad their own bottom line. Based on these concerns, it is vital for the Committee to understand what actions CMS is taking to prevent abuse in the Medicare Part D program,” concluded Chairman Comer.

Read the letter to CMS here.