HHS is not going to readjust Medicare Part B premiums this yr


Medicare beneficiaries who had hoped to receive some relief from the 14.5% increase in Part B premiums this yr are going to be disillusioned, but they may even see lower premiums next yr.

Medicare Part B premiums, which cover doctors’ fees and outpatient services, rose from $148.50 per 30 days in 2021 to $170.10 per 30 days this yr. When the 2022 premium was announced last November, the Centers for Medicare and Medicaid Services said the unusually large increase was driven partly by the statutory requirement to arrange for potential expenses, equivalent to spending trends driven by COVID-19 and the uncertain pricing and utilization of Aduhelm, a recent drug to treat Alzheimer’s disease.

On the time CMS announced the 2022 premium in the autumn of 2021, Aduhelm cost a mean of $56,000 per yr. After the 2022 Medicare Part B premium was set, the manufacturer of Aduhelm reduced the worth to a mean of $26,200.

In January, Department of Health and Human Services Secretary Xavier Becerra instructed CMS to reassess the 2022 Part B premium amount in response to the reduction in the worth of Aduhelm.

On Friday, CMS announced that any savings resulting from changes in the fee of Aduhelm shall be reflected within the 2023 Medicare Part B premium. “Given the knowledge available today, it is anticipated that the 2023 premium shall be lower than 2022,” the announcement said. The ultimate premium determination shall be made this fall.

In a report accompanying the announcement, CMS determined that it was impractical to try to regulate Medicare Part B premiums mid-year in 2022.

“Such a change would require the retroactive processing of million of claims which might take over a yr and extra resources to finish,” in line with the report. It also determined that CMS doesn’t have sufficient authority to send premium refunds on to beneficiaries.  

“CMS found that incorporating the premium effects of Aduhelm’s price reduction … into the 2023 premium is the one practically feasible option,” the report said.

(Questions on recent Social Security rules? Find the answers in Mary Beth Franklin’s recent 2022 ebook at MaximizingSocialSecurityBenefits.com)

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