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Accession Number
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PB2013-101727
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Title
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Medicare Part D Coverage Gap: Discount Program Effects and Brand-Name Drug Price Trends.
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Publication Date
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Sep 2012
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Media Count
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47p
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Personal Author
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N/A
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Abstract
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As part of Medicare's Part D Coverage Gap Discount Program (Discount Program), the Centers for Medicare & Medicaid Services (CMS), located within the Department of Health and Human Services (HHS), oversees the provision of discounts by plan sponsors to eligible beneficiaries when they purchase brand-name drugs and monitors that discounts are paid for by drug manufacturers. CMS checks prescription drug data to verify that sponsors provide accurate discounts at the point-of-sale to eligible beneficiaries in the coverage gap. These checks include verifying whether a beneficiary has reached the coverage gap and that the plan sponsor has calculated the discount amount correctly. CMS also tracks that manufacturers pay plan sponsors for the discounts sponsors have provided to beneficiaries and has implemented a dispute resolution process for manufacturers disputing discount payment amounts. CMS also performs other activities such as monitoring beneficiary complaints related to the program.
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Keywords
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Brand-name drugs
Discount programs
Drug costs
Drug manufacturers
Medicare
Patient Protection and Affordable Care Act
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Source Agency
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General Accounting Office
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NTIS Subject Category
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44K - Health Services
57E - Clinical Medicine
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Corporate Author
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Government Accountability Office, Washington, DC.
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Document Type
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Technical report
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Title Note
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N/A
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NTIS Issue Number
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1303
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Contract Number
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N/A
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