Inflation Rebates in Medicare

Inflation Rebates in Medicare

 

ira payment

The prescription drug law, known as the Inflation Reduction Act, requires drug companies that raise the prices of certain drugs covered under Part B and Part D faster than the rate of inflation to pay Medicare a rebate.
 

Guidance for the Inflation Rebate Program

Fact Sheet: Medicare Prescription Drug Inflation Rebate Program Revised Guidance (PDF) (December 14, 2023)

Fact Sheet: Medicare Prescription Drug Inflation Rebate Program Initial Guidance (PDF) (February 9, 2023)

Medicare Part B Guidance

Medicare Part B Inflation Rebate Program Revised Guidance (PDF) (December 14, 2023)

Revised Part B Inflation Rebate Guidance: 340B Modifier (PDF) (December 14, 2023)

Medicare Part B Inflation Rebate Program Initial Guidance (PDF) (February 9, 2023)

Part B Inflation Rebate Guidance: 340B Modifier (PDF) (December 20, 2022)

Medicare Part D Guidance

Medicare Part D Inflation Rebate Program Revised Guidance (PDF) (December 14, 2023)

Medicare Part D Inflation Rebate Program Initial Guidance (PDF) (February 9, 2023)

Public Comments on Initial Rebate Guidance

Public Comments: Medicare Inflation Rebate Program Initial Guidance (ZIP) (submitted by March 11, 2023)

 

Coinsurance Adjustment for Part B Rebatable Drugs

Beginning April 1, 2023, people with Medicare started to see lower out-of-pocket costs for certain Part B drugs and biologicals with prices that have increased faster than the rate of inflation. For these drugs and biologicals, the beneficiary coinsurance is 20 percent of the inflation-adjusted payment amount, which is less than what the beneficiary would pay in coinsurance otherwise.

Fact Sheet: Part B Rebatable Drug Coinsurance Reduction (PDF) (March 2, 2023)

Quarterly Updates to Part B Coinsurance Adjustment 

Reduced Coinsurance for Certain Part B Rebatable Drugs (April 1 - June 30, 2024) (PDF)

Reduced Coinsurance for Certain Part B Rebatable Drugs (January 1 - March 31, 2024) (PDF)

Reduced Coinsurance for Certain Part B Rebatable Drugs (October 1 - December 31, 2023) (PDF)

Reduced Coinsurance for Certain Part B Rebatable Drugs (July 1 - September 30, 2023) (PDF) 

Reduced Coinsurance for Certain Part B Rebatable Drugs (April 1 - June 30, 2023) (PDF)

 

Information Collection Requests (ICRs)

The Rebate Reduction Requests under Sections 11101 and 11102 of the Inflation Reduction Action ICR can be found in the Federal Register. The full text of the ICR can also be found at CMS's PRA Listing website. The 60-day comment period closes on March 29, 2024, and comments can be submitted at this comment submission link.

Page Last Modified:
03/26/2024 08:40 AM