The Centers for Medicare & Medicaid Services (CMS) released draft guidance for comment on August 21, outlining the requirements and procedures for certain aspects of the new Medicare Prescription Payment Plan.

The program, authorized under the Inflation Reduction Act, gives individuals with Medicare prescription drug coverage (Medicare Part D) the option to pay out-of-pocket costs in monthly payments spread out over the year starting in 2025. This applies to all Part D sponsors, including stand-alone plans, Medicare Advantage plans with prescription drug coverage, as well as Employer Group Waiver Plans, cost plans and demonstration plans.

The draft guidance focuses on assisting Medicare Part D plan sponsors and pharmacies prepare for the new program. Given the size of the new program, CMS is releasing the guidance in two parts. Additional draft guidance will be released for comment in early 2024.

Also see the fact sheet and an implementation timeline for the program.