CMS Releases Analysis on 2022 Medicare Part B Premium Reexamination | CMS
today, the centers of medicare & Medicaid Services (CMS) released a report recommending that cost savings from lower-than-expected Medicare Part B expenses be passed on to people with Medicare Part B coverage in calculating premium 2023 Part B Premium. Earlier this year, Department of Health and Human Services (HHS) Secretary Xavier Becerra instructed CMS to reassess the 2022 Part B premium amount in response to a reduction of the price of aduhelm™, a monoclonal antibody directed against amyloid for use in the treatment of Alzheimer’s disease. Given the information available today, the 2023 premium is expected to be lower than the 2022 premium. A final determination will be made later this fall.
“Under the Secretary’s direction, CMS reassessed the Medicare Part B premium and recommends that the identified savings be incorporated into the Medicare Part B premium by 2023,” said Chiquita Brooks-Lasure, cms administrator “Due to changes in the cost of aduhelm™ and coverage since the premium was established, cms recommends that the underspend in 2022 be incorporated into the 2023 part b premium determination. harris remains committed to lowering health care costs for beneficiaries by increasing price transparency, lowering the cost of prescription drugs, and connecting people with savings programs.”
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medicare part b covers physician services, hospital outpatient services, certain home health services, durable medical equipment, and certain other health and medical services not covered by medicare part a, which covers inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery, home health care.
as detailed in the report, when calculating the part b premium, cms creates a reserve to ensure that the medicare supplemental medical insurance (smi) trust fund remains adequately funded during the year. In 2022, CMS appropriately entered a reserve to ensure that the SMI Trust Fund could cover the potential costs of Aduhelm™ and similar medications. at the time cms announced the premium in fall 2021, aduhelm™ cost an average of $56,000 per year and cms had not yet issued a national coverage determination (ncd). after the medicare part b premium was set for 2022, the maker of aduhelm™ lowered the price to an average of $26,200, and cms ended medicare coverage with the development of evidence for aduhelm™ and similar approved future drugs by the fda with an indication for use in the treatment of alzheimer’s disease. cms determined that reflecting these savings in the 2023 medicare part b premium calculation is the most effective way to pay these savings back to people with medicare part b. cms is still evaluating other current and projected medicare part b costs to inform the 2023 premium recommendation, to be announced in fall 2022 in accordance with legal process.
in november 2021, cms announced that the standard monthly part b premium increased from $148.50 in 2021 to $170.10 in 2022. this increase was due in part to the legal requirement to prepare for potential expenses, such as spending trends driven by covid-19 and uncertain aduhelm™ pricing and usage. Despite the increase, most people on Medicare saw a significant net increase in Social Security benefits due to a higher-than-usual cost-of-living adjustment (tail) in 2022.
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People with Medicare coverage may be eligible for help paying their Medicare costs through the Medicare Savings Programs (MSP). cms encourages people with medicare to verify their eligibility for financial assistance from msp, as they can also help pay for medicare part a (hospital insurance) and medicare part b (medical insurance) deductibles, coinsurance, and copayments if individuals meet the eligibility criteria. People with Medicare can get more information about Medicare savings programs by calling 1-800-medicare or visiting medicare.gov at https://www.medicare.gov/your-medicare-costs/get-help-paying- costs/medicare-savings-programs.
The 2022 Medicare Part B Premium Review Report and Analysis is available at www.cms.gov/files/document/cms-report-secretary-2022-medicare-part-b-premium -reexamination.pdf.
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