CMS on Monday unveiled a new model for Medicare Part D to test lowering out-of-pocket insulin costs for diabetics on some of the privately run prescription drug plans. The voluntary model puts a $35 cap on copays for a 30-day supply of insulin throughout the benefit year for eligible enrollees. CMS said initial projections assume it could save more than $250 million in over five years for the federal government, largely due to pharmaceutical manufacturers paying additional coverage gap discounts. Some commercial payers have already made similar moves to lower insulin costs, such as Cigna and Express Scripts. CMS is requesting applications from pharmaceutical manufacturers and sponsors to apply for the new model, which is expected to launch in January.
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Source: https://www.healthcaredive.com/news/cms-launches-payment-model-designed-to-lower-out-of-pocket-insulin-costs/574012