Inflation rebates to reduce Medicare payment for 41 Part B drugs

This April through June under the Inflation Reduction Act, Medicare will reduce the coinsurance amount for 41 Part B prescription drugs from 20% to somewhere between 3.8% and 19.9%, depending on the drug, the Centers for Medicare & Medicaid Services announced March 26. Medicare will pay health care providers the difference between the Medicare allowed amount and the adjusted beneficiary coinsurance, after applying the Part B deductible and prior to sequestration, if applicable.

The IRA requires drug companies to pay rebates to Medicare when prices for certain single-source and biosimilar prescription drugs covered under Part B increase faster than the rate of inflation. Part B drugs impacted by a coinsurance adjustment may change quarterly. For more information, see the CMS fact sheet.