Biden administrator finalizes rule that requires insurers to submit data on drug costs and discounts


The Biden administration has issued an interim final rule that requires private insurers to report prescription drug costs to the federal government.

The interim rule, which also includes a request for comment, is the latest in a series of regulations implementing the provisions of the No Surprises Law and the Consolidated Appropriations Law of 2021. Insurers offering l-sponsored coverage An employer, other group plans, or individual plans must submit key drug cost data to the departments of Health and Human Services (HHS), Labor, and the Treasury.

According to an announcement from the Centers for Medicare and Medicare Services (CMS).

Data submission is to begin with calendar year 2020 information, but agencies will delay application until December 27, 2022, to allow insurers to come into compliance.

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Data for 2020 and 2021 will be due by that date, CMS said, although insurers can submit it earlier. The agency said it plans to release its first report in June 2023 and then every two years.

“Prescription drugs that save lives shouldn’t cost anyone their savings,” HHS Secretary Xavier Becerra said in a statement. “Today, the Biden-Harris administration is taking additional steps to make health care more accessible and affordable for patients.”

“By collecting key data on prescription drug costs, we promote competition and transparency in the healthcare industry as we continue to curb rising drug costs and surprise medical bills,” said Becerra.

A rule information sheet provides more details on the required data. Each year, insurers will be asked to provide information such as the 50 most frequently dispensed brand-name drugs, the 50 most expensive drugs based on total spending, and the 50 drugs with the largest increase in plan or plan spending. year-to-year coverage.

Insurers will also be required to submit data on discounts, fees and other compensation paid by drug companies to the plan in each therapeutic class, as well as the 25 products that gave the most discounts. They should also include information on the impact of discounts on premiums and out-of-pocket expenses, according to the fact sheet.

“With today’s rule, we are taking more steps to make sure the care people receive is affordable,” CMS administrator Chiquita Brooks-LaSure said in a statement. “As we build on our previous efforts to implement the No Surprises Act, we will be monitoring pricing and premium trends to better identify barriers to the low-cost, comprehensive, people-centered care we all deserve. “

Comments on the interim final rule are expected on January 24, 2022.

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