Legislation Introduced to Lower Prescription Drug Costs for Seniors with Chronic Conditions

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If you’re a senior enrolled in the Program of All-Inclusive Care for the Elderly (PACE), legislation just
introduced will enable you to choose your Medicare Part D plan for prescription drugs, which will reduce
overall costs. Senators Tom Carper and Bill Cassidy of Louisiana proposed the legislation, which would
save Medicare-only PACE participants an average of nearly $1000 a month on life-saving prescription
drugs. The program is a comprehensive, provider-based health plan that serves over 62,000 older
Americans with chronic illnesses and functional disabilities.

Additional Information from the United States Senate press release:

“PACE participants in Delaware and across our nation are dealing with rising prescription drug costs every time they need a refill for their live-saving medications. It makes no sense that these older Americans cannot choose which Medicare Part D plan makes the most financial sense for them,” said Carper. “I’m glad to introduce this bipartisan legislation that would give these individuals a choice, lowering monthly costs and, thanks to the Inflation Reduction Act, ensuring PACE participants won’t pay a dime over $2,000 a year for their medications. I urge my colleagues to join me in supporting this overdue legislation, and hope to see it reach the President’s desk by years-end.”

U.S. Senators Tom Carper (D-Del.), senior member of the Senate Finance Committee, and Bill Cassidy (R-La.) today introduced the PACE Part D Choice Actlegislation that will enable older Americans enrolled in the Program of All-Inclusive Care for the Elderly (PACE) to choose their Medicare Part D plan for prescription drugs to lower overall costs. Specifically, this legislation will save Medicare-only PACE participants an average of $972.03 a month on life-saving prescription drugs.

“This bill ensures patients in the PACE program have the same access to lower premiums and affordable prescription drugs that lead to better health outcomes as those in other Medicare programs,” said Dr. Cassidy.

“PACE is a proven model of care for the elderly, and it has continued to demonstrate its benefits even more profoundly during the pandemic,” said Shawn Bloom, President and CEO of the National PACE Association. “But widespread enrollment in PACE for the millions of Medicare-only beneficiaries who could benefit faces a significant financial obstacle –the high Part D premium cost. NPA urges Congress to pass this bill quickly so that many more older adults and their families can be served by PACE and receive the care they need in their homes and communities.”

Background:

The Program of All-Inclusive Care for the Elderly (PACE) is a comprehensive, provider-based health plan with a proven track record of high-quality care for people with chronic illnesses and functional disabilities. Today, PACE serves over 62,000 older Americans who have complex, chronic medical conditions and need long-term services and supports. Less than 1% of these participants have Medicare-only coverage.

Currently, PACE participants are required to use PACE Part D coverage for all covered prescription drug costs, which have an average monthly premium of $1,015.03. Senators Carper and Cassidy’s legislation will allow PACE participants to choose between the existing PACE Part D plan or a stand-alone Part D plan, which instead has a monthly average premium of $43 – saving individuals an average of $972.03 a month on prescription drugs. By allowing Part D plan choice, Congress would be able to increase affordability and access to PACE for Medicare-only participants and for future Medicare beneficiaries.


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