Letter to CMS on the Medicare Part D and Medicare Advantage Rule

By at 30 October, 2014, 1:17 pm

Marilyn Tavenner

Administrator, Centers for Medicare & Medicaid Services

Department of Health and Human Services

7500 Security Boulevard, Baltimore, MD 21244


Dear Administrator Tavenner:

On September 18, at the Government Oversight and Government Reform Committee hearing on implementation of the Affordable Care Act, you committed to not resurrect policies included in the 2015 Medicare Part D and Medicare Advantage (MA) proposed rule that were subsequently excluded from the final regulation. Partly in response to bipartisan Congressional pressure and hundreds of patient, provider, employer and insurer organization comments, the final rule did not adopt the most controversial provisions included in the proposed regulation.

We applaud your remarks and appreciate your commitment to the final rule and its policies.

Our broad-based alliance has a singular focus: bringing down the cost of health care for all Americans. Our membership reflects a broad range of interests—organizations representing small and large employers, manufacturers, insurers, brokers and agents, retailers, physician organizations and consumers. We have expressed concern in the past that some policies pursued by the Administration would raise taxpayer or beneficiary costs, or both.

Particular concerns in the proposed Part D rule that were not adopted in the final rule were: limits to competition through arbitrary limits on plan offerings; changes to pharmacy networks; changes to the six protected classes of drugs; and reinterpreting the so-called “non-interference” provision. Taken together, these provisions would have unnecessarily and fundamentally reconstructed the very successful Medicare Part D program.

Finally, the proposed rulemaking process is important in ensuring that stakeholders have input into federal rulemaking. We encourage CMS to encourage more, not less participation, in soliciting comments and feedback on proposed policy changes. As an organization that is at the crossroads of employers, health plans, providers and consumer groups, we understand the value of predictability and consistency. For these reasons, we appreciate your commitment to stand by the final 2015 Part D and Medicare Advantage rule by rejecting the policies offered in the 2015 proposed rule.

We look forward to continuing to work with you and the Agency to ensure the Medicare Part D program remains successful in the future.


American Academy of Ophthalmology

Chamber of Commerce

Communicating for America

Council for Affordable Health Coverage

Healthcare Leadership Council

National Association of Health Underwriters

National Association of Manufacturers

National Association for the Self-Employed

Pharmaceutical Care Management Association

Small Business & Entrepreneurship Council 

CC: Secretary Burwell

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