The authors submitted the comment letter to the Centers on Medicare and Medicaid Services on June 25, 2025.
Samuel R. Bagenstos, Richard G. Frank, Kristi Martin, Rachel E. Sachs, and Christen Linke Young provide the Centers for Medicare and Medicaid Services with comments on the draft guidance of the Medicare Drug Price Negotiation Program. This comment focuses on Section 30.2 and the identification of Part B high spend drugs. Specifically, this group of experts in policy, operational, and legal issues affecting the Medicare Drug Price Negotiation Program believes the identification of Part B high spend drugs under section 1192(d)(1)(B) of the Social Security Act can and should account for spending on Part B drugs administered to Medicare Advantage enrollees. The comment letter makes three key points regarding the inclusion of such spending:
- Failure to include Medicare Advantage usage distorts the proper functioning of the law
- Section 1192(d)(1)(B) is best read to include Medicare Advantage expenditures
- Inclusion of Medicare Advantage usage is operationally feasible
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Commentary
Comments on Medicare Drug Price Negotiation Program’s Section 30.2 and Part B high spend drugs
July 14, 2025