CMS Announces Medicare Part D Demonstration, Methamphetamine Use Disorder Breakthrough


“This hasty midnight regulation is a step against some of the most vulnerable people in our communities and the bipartisan lawmakers who have tirelessly defended the merits of Medicare’s protected classes policy. We look forward to working with the Biden administration and Congress to ensure we give people in our nation with the most complex conditions – including cancer, mental illness, HIV-AIDS, epilepsy, Parkinson’s and organ transplantation – access to the medication they need to best achieve the next step of a treatment plan. – Chuck Ingoglia, in response to the Centers for Medicare & Medicaid Services (CMS) announcing a new Part D demonstration that would remove certain drugs from the six protected classes.

Trump Administration Announces Last Minute Medicare Part D Demonstration

Late Tuesday, CMS announced new flexibilities (Request for ApplicationsFact Sheet) that will allow Medicare Part D plans that participate in the third year of the Center for Medicare and Medicaid Innovation’s (CMMI) Part D Payment Modernization (PDM) Model to limit the drugs they cover. The application announcement offers new flexibilities beyond what was offered in the first two years of the model. Effectively, the change would permit plans to cover only one drug per therapeutic class and treat five of Medicare’s six protected classes as if they were any other class of drug, no longer requiring coverage of “all or substantially all” of the drugs in those classes. CMS says that the sixth protected class — antiretrovirals — will also be treated as any other class for CY 2023. The model is not open for a public comment period. If implemented, it would undermine access to medications used by our patient communities. Stay tuned for more on our efforts to combat this restriction to lifesaving prescription drugs.

Methamphetamine Use Disorder Breakthrough, New HHS Guidelines for Buprenorphine

Last week, the New England Journal of Medicine released a randomized control trial (RCT) study on the use of bupropion and naltrexone for the treatment of methamphetamine use disorder (MUD). Among the 403 study participants, nearly 14% of those who took the combination presented mostly drug-free urine samples. Currently, there are no medications on the market to treat methamphetamine use disorder treatment, making the results of the study extremely promising. Also last week, HHS announced new guidelines allowing physicians to more easily prescribe the opioid addiction treatment buprenorphine to patients. Now, any physician can prescribe buprenorphine (any formulary) to a person with an opioid use disorder (OUD). The prescribing cap for non-waivered physicians is 30 patients unless they are in a hospital setting.

Biden Administration Releases COVID-19 Proposal

President Joe Biden recently released the first phase of his COVID-19 plan, detailing $1.9 trillion in “rescue” priorities for Congress as he looks to ramp up the federal government’s efforts to stamp out the pandemic. The proposal is divided into three main areas: (1) $400 billion toward a national testing and vaccination plan; (2) over $1 trillion in direct relief to families; and (3) $440 billion in aid to communities and businesses. President Biden intends to release the “recovery” phase of his plan in February, which is widely expected to include broader economic stimulus measures, such as a comprehensive infrastructure package and additional tax relief.

NatCon21 Registration is Now Open!

Registration for NatCon21 – the largest conference in mental health and addiction care – is now open! Join us from May 3-5 to experience hundreds of speakers, a game-changing curriculum, dynamic presentations, and industry-advancing discussions – everything you need to boost your operations, impact, and bottom line! Take advantage of our early bird rate – register today.


Take Action: Urge Congress to Include Adults with Disabilities in Stimulus Payments. The COVID-19 relief bills passed by the previous Congress left out important members of our community – adult dependents. Adults with disabilities who are claimed as dependents did not receive money from either round of stimulus payments. The 117th Congress must work to ensure that all adult dependents are eligible for any future payments. Act today to ensure adults with disabilities who are claimed as dependents receive stimulus payments in future relief legislation.

Register today: The Congressional Management Foundation is conducting a webinar on Tuesday, February 2, from 3-4 pm ET titled: “The Virtual Advocacy Toolkit & How to Conduct a [Virtual] Meeting with Congress.” The presentation will highlight and provide tips for effectively using virtual advocacy strategies for engaging lawmakers including virtual meetings, emailing staff, social media, online and telephone town hall meetings, and more. Register here.


Inauguration. On Wednesday, January 20th, Joseph R. Biden, Jr. was inaugurated as the 46th President of the United States.

Guest Author

Malka Berro
Policy Associate