Medicare Part D

Floor Speech

Mr. CARPER. Mr. President, while Medicare Part D has been a very popular program and has improved access to tens of millions of patients, the donut hole has been a continuing source of frustration for many beneficiaries. The Patient Protection and Affordable Care Act begins to fill in the ``donut hole'' with a 50 percent discount program that will begin in 2011. The purpose of the coverage gap discount was to provide relief for those beneficiaries who struggle with paying for medications in the coverage gap and, as a result, stop taking medicines as prescribed or cut back on their monthly medication use.

The Centers for Medicare and Medicaid Services recently released guidance to Part D plans regarding the administration of the Part D coverage gap discount. In that guidance, CMS responded to comments that sought clarification on the relationship between the 50 percent discount program and existing Part D rebate contracts. Although the CMS guidance clarified that manufacturers would continue to negotiate with Part D plans to provide rebates, I feel the need to further clarify this issue.

Any interference by CMS with price negotiations between manufacturers and Part D plans would be counter to the explicit intent of Congress through the government noninterference clause. With the passage of PPACA, and specifically the Part D Coverage Gap Discount Program, the government non-interference clause continues to be the existing law; therefore, CMS does not have the authority to require manufacturers to provide rebates at any particular level.

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