Removal of safe harbor affects EGWPs

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By Stephen Kaczmarek | 02 May 2019
A proposed rule from the Department of Health and Human Services would revise the safe harbor protection in Medicare Part D that currently allows pharmaceutical manufacturer rebates to be paid after the point-of-sale and start requiring such rebates to be credited against the drug’s point-of-sale price. This change could dramatically reduce the member’s cost of many brand-name drugs that receive rebates for Medicare beneficiaries. It also affects employer group waiver plans (EGWPs) and merits immediate action on the part of plan sponsors and insurers offering insured EGWPs.