MEdicare Support and Policy
News & Updates
Medicare Part D – January 2021
In January 2020, the Centers for Medicare and Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (Innovation Center) began the Part D Payment Modernization Model to test the impact of a revised Part D program design and incentive alignment on overall Part D prescription drug spending and beneficiary of out-of-pocket costs.
Just before midnight of Trump’s Administration, he made a final attempt to undermine and compromise access to critical care services for people with chronic illness by signing last minute tactics to erect unnecessary barriers that will harm American patients. Instead of increasing access to healthcare in the middle of the Covid-19 pandemic, he jeopardized protected access to patients with HIV, cancer, epilepsy, severe mental illness, organ transplant survivors, anti-seizure and anti-psychotics. In January 2019, the Center for Medicare and Medicaid Innovation (CMMI) launched a voluntary five-year Part D Payment Modernization Model, which offered the opportunity to modify some program requirements with the aim of lowering costs to Medicare Part D and seniors that went into effect in 2020. One more disaster he has created. Contact your Congressman and Senators ask them to overturn it.
Medicare Part B and Part D Programs ---
President Trump Administration's Most-Favored Nation (MFN) Executive Order
To raise awareness about the Trump Administration's Most-Favored Nation (MFN) executive order signed on September 13, 2020 and the potential impact this disastrous policy will have on biopharmaceutical industry and US patient access to lifesaving treatments. The Trump Administration’s final Most Favored Nation executive order will have a significant and negative impact on American patients because it imposes destructive foreign price control policies over both Medicare Part B and Part D prescription drugs. This will unravel an important program that millions of patients depend on especially during the COVID-19 crisis. This EO will also stifle American medical innovation including new treatments and a vaccine for COVID-19.
The Trump Administration’s new Most Favored Nation EO would harm patient access to lifesaving treatments received under both the Medicare Part B and Part D programs. The absence of price controls in the U.S. leads to more and newer medicines available sooner to Americans. Of the 65 cancer drugs launched between 2011-2017, 95% are available in the United States, compared with 75% in the UK, and 51% in Japan. If this EO is finalized, American’s will have access to fewer innovated medicines than they do today. Any health care policy that reduces access and impedes medical innovation is unacceptable.
Medicare Part B – August 2020
Administration’s 2018 proposed “International Pricing Index Model of Medicare Part B Drugs. This model would change the US healthcare system and adopt a system to reflect the pricing and treatment policies found in other countries with single payer systems. Basically, this model would impose foreign price controls on certain prescription drugs.
We believe basing payments in Medicare Part B on what other countries with socialist health care systems pay would be devastating for patients in the US because it would significantly limit access to critical medicines and treatments. In fact, the White House Counsel of Economic Advisors recently pointed in out that, U.S. cancer patients survive longer than those in all other European Union countries because U.S. citizens have more access to the newest treatments.
History has shown that government-imposed price controls consistently cause shortages, and delays in both available as well as access to innovative treatments.
Please contact your Congressman and Senators and inform them of the many flaws in the President’s “Healthcare Plan.” Many of the people we have helped are now leading normal lives because they were prescribed pharmaceuticals developed by our American Pharmaceutical Companies and sold at American Pharmacies.
Recent proposals in Congress would drastically impact Medicare beneficiaries by linking U.S. health care costs to foreign countries and encouraging government price controls. We ask Sen. Mike Lee, Sen. Mitt Romney, Rep. Rob Bishop, Rep. Chris Stewart, Rep. John Curtis and Rep. Ben McAdams to actively oppose any policies that would be harmful to Utah’s nearly 390,000 Medicare beneficiaries. Utah's representatives should support patient-centered reforms that cap out-of-pocket drug spending in Medicare Part D and ensure pharmaceutical discounts negotiated by insurance companies are shared with patients at the pharmacy counter
Recent proposals in Congress would drastically impact Medicare beneficiaries by linking U.S.
health care costs to foreign countries and encouraging government price controls. We ask Sen.
Mike Lee, Sen. Mitt Romney, Rep. Rob Bishop, Rep. Chris Stewart, Rep. John Curtis and Rep.
Ben McAdams to actively oppose any policies that would be harmful to Utah’s nearly 390,000
Medicare beneficiaries. Utah's representatives should support patient-centered reforms that
cap out-of-pocket drug spending in Medicare Part D and ensure pharmaceutical discounts
negotiated by insurance companies are shared with patients at the pharmacy counter
Letter to our representants and Senators
October 11, 2019
The Honorable Sen. Mike Lee
The Honorable Sen. Mitt Romney
The Honorable Rep. Rob Bishop
The Honorable Rep. Chris Stewart
The Honorable Rep. John Curtis
The Honorable Rep. McAdams
Dear Mr. Lee, Mr. Romney, Mr. Bishop, Mr. Stewart, Mr. Curtis and Mr. McAdams,
We are writing to encourage you to consider the nearly 390,000 seniors and people living with
disabilities enrolled in Medicare in Utah as you carefully review potential changes to Medicare.
We applaud efforts to lower costs for beneficiaries, but maintaining comprehensive coverage,
access to care, and competition are essential for Utah seniors. For example, in Utah,
beneficiaries are able to choose between 26 different Part D plans to allow them to select the best
coverage for their health needs. This competition is one of the reasons why seniors continue to
be happy with the program. In a 2019 Senior Satisfaction Survey conducted by Medicare Today,
93% of beneficiaries said the Part D program is convenient to use and 84% said premiums are
There are two proposals currently being considered in Congress that would help lower costs for
seniors. One would reform the rebate system in the pharmaceutical supply chain. This would
ensure that the steep discounts negotiated by the manufacturers, pharmacy benefit managers, and
insurance companies make their way to patients at the pharmacy counter. We also support
legislative efforts to implement an annual out-of-pocket cap for prescription drug spending and
lowering what people pay in Part D. An annual out-of-pocket cap is a commonsense reform that
would lower patient cost-sharing and improve Part D drug affordability, while still maintaining
access to a wide-range of drugs.
Conversely, there are two policy proposals that we think would be harmful to Utah’s Medicare
beneficiaries. We are particularly concerned about efforts to link U.S. health care costs to 14
other countries, most of which have government-run health care systems. One such proposal,
known as the International Price Index model, would drastically alter the way Medicare
reimburses and distributes medicines within the Medicare Part B program. The unintended
consequence of linking U.S. prices to other countries is that our patients would face the same
access restrictions that patients in the identified reference countries have – a harsh reality for
those who are battling serious illness such as cancer or autoimmune diseases.
Finally, we are opposed to legislative proposals that would undermine the competitive structure
of Medicare Part D, such as repealing the non-interference clause, implementing inflation
penalties, or other proposals that would lead to government price controls. We believe treatment
decisions should be made by a patient and a doctor, not government officials. Government
interference would restrict access for patients and could thwart the advancement of innovative
treatment options, and even cures, for years to come.
In short, as you consider legislative changes to Medicare this fall, we hope that you support
patient-centered policies to reduce out-of-pocket costs with continued access to treatment options
for Utah’s seniors.
Centro Civico Mexicano
Dyson and Associates
First Step House
Inclusion Center for Community and Justice
NAACP – Ogden Chapter
Northern Utah Coalition, Inc.
Project Success Coalition
Utah Support Advocates for Recovery Awareness