Republicans Ask GAO If CMS’ Proposed Part D Premium Stabilization Program Is Legal
A group of House and Senate Republicans are asking the congressional Government Accountability Office (GAO) if the Centers for Medicare and Medicaid Services’ (CMS) proposed additional premium stabilization program for standalone Part D (PDP) plans is legal. CMS announced the creation of the program after it received bids that showed premiums would skyrocket despite some protections in the Inflation Reduction Act (IRA).
The Part D changes in the IRA were much touted as protecting consumers by lowering out-of-pocket (OOP) costs. It also shifted huge costs to plans. These changes were not adequately funded by the government and thus plans had to reduce benefits in other areas and increase premiums. CMS was caught flat-footed and quickly created the program recently to avoid an October Surprise during open enrollment. I have issues with whether CMS has the statutory authority to do this despite broad waiver authority. It will further deplete sparse Medicare funds.
The GOP lawmakers asked the GAO whether the new demo is consistent with the law, to investigate what budgetary analysis CMS did when developing the program, to determine the projected costs, and whether it meets budget neutrality requirements.
See my earlier blogs on this subject: https://www.healthcarelabyrinth.com/part-d-premium-woes-due-to-the-inflation-reduction-act/ and https://www.healthcarelabyrinth.com/will-democrats-be-victim-of-an-october-surprise-of-their-own-making/ .
(Article may require a subscription.)
#medicareadvantage #pdp #partd #cms #ira