Part D Payment Modernization Model

CMS recently released an RFA1 for the Part D Payment Modernization (PDPM) model which includes several unique opportunities intended to incentivize plans to actively manage beneficiary out-of-pocket costs and overall drug costs, particularly drug costs in the catastrophic phase of the benefit. While the PDPM is an ongoing demonstration that has been active for the last two years, CMS added additional flexibilities to the 2022 application in the hopes of garnering more interest and participation from plans.