New Senate bill seeks to add Part D options for PACE beneficiaries

New legislation aims to ensure that certain Medicare beneficiaries with chronic conditions could get a standalone Part D plan to help lower drug costs.

The legislation, introduced Wednesday by Sens. Bill Cassidy, M.D., R-Louisiana, and Tom Carper, D-Delaware, focuses on seniors enrolled in the Medicare-Medicaid Program of All-Inclusive Care for the Elderly (PACE). The goal of the program is to lower Part D premiums for such seniors, which get care for complex and chronic conditions that need long-term support. 

“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 Cassidy in a statement.

Currently, seniors on PACE must get the program’s Part D coverage for any drug costs, which can have an average monthly premium of $1,015, according to a release on the legislation. 

However, the bill would ensure that a senior could instead pick a standalone Part D plan, which features a monthly premium of $43. 

“It makes no sense that these older Americans cannot choose which Medicare Part D plan makes the most financial sense for them,” Carper said in a statement. 

The legislation comes as federal regulators are implementing an inflationary cap on Part D drug costs passed as part of the Inflation Reduction Act. The law, passed earlier this year, also includes a $35 monthly cap on insulin for Medicare beneficiaries. 

Cassidy and Carper’s bill is being introduced very close to the end of the latest congressional session, as lawmakers returned this week for a short lame-duck session after the midterm elections. However, several lawmakers and advocates have been eyeing a must-pass spending package as a vehicle to move several healthcare policies.

Advocacy groups believe the package—which must pass by Dec. 16 or the federal government shuts down—can include other policy items like delays to several cuts to Medicare payments.