High prescription drug costs burden Americans, especially seniors and those with disabilities on Medicare. The Inflation Reduction Act addresses this by allowing Medicare to negotiate drug prices, capping out-of-pocket expenses at $2,000 for Part D beneficiaries, and introducing the Medicare Prescription Payment Plan (MPPP) for monthly billing options, easing financial strain and improving budget management.
To ensure seamless compliance with MPPP requirements, health plans must adhere to essential timelines throughout the preparation and implementation phases. We are pleased to present this Everest Group report that demystifies MPPP for payers and pharmacy benefit management (PBM) players.
This report outlines the key timelines, objectives, and cost-sharing methodologies of MPPP, along with roles for payers and PBMs, implementation components, future use cases, and performance governance through operational KPIs. It provides a comprehensive guide for health plans to navigate and optimize MPPP participation.
Sneak Peek into the Report:
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