Insurers, PBMs call on Congress to get rid of delayed Part D rebate rule

Insurer and PBM groups are not happy with a 1-year delay of the implementation of a controversial Medicare Part D rebate rule. In a letter to congressional leaders, the groups said they now want Congress to fully eliminate the rule, which was approved near the end of the Trump administration. They wrote, “The rebate rule was and remains unsound policy. We believe it is imperative to block implementation of this rule to protect Medicare beneficiaries and taxpayers from unsustainable cost increases.” The Pharmaceutical Care Management Association (PCMA) signed the letter alongside America’s Health Insurance Plans and the Blue Cross Blue Shield Association. The Better Medicare Alliance and the Coalition for Affordable Prescription Drugs were also among the 16 groups that signed the letter. The rule would remove the safe harbor for Part D drug rebates, meaning the rebates would be subject to prosecution under federal anti-kickback laws. In its place, a new safe harbor would be formed to apply to discounts offered at point of sale. The removal of the safe harbor was originally set to occur on January 1, 2022, but the Biden administration delayed it until January 1, 2023. HHS said in a court order in January that it was reviewing the rule. PCMA has sued HHS to remove the rule, but that case was suspended after the Biden administration announced the 1-year delay.