White House Announces First 10 Drugs Subject to Medicare Price Negotiations
Sep 26, 2023
White House Announces First 10 Drugs Subject to Medicare Price Negotiations

On Tuesday, Aug. 29, the Biden administration unveiled the first 10 prescription drugs subject to Medicare price negotiations. Medicare provides health insurance coverage to 65 million Americans, including 57 million seniors.


More than 60% of the 65 million people on Medicare take prescription medication, and 25% take at least four prescriptions, according to a Kaiser Family Foundation survey.


Under the Inflation Reduction Act, the Medicare Drug Price Negotiation Program allows the federal government to negotiate directly with drug manufacturers to improve access to some of the costliest brand-name drugs. Many Medicare Part D enrollees depend on medications to treat life-threatening conditions, such as diabetes and heart failure, but may not be able to access them due to costs. The following Medicare Part D drugs will be the first ones subject to these negotiations:


  • Eliquis, for preventing and treating blood clots
  • Jardiance, for treating diabetes and heart failure
  • Xarelto, for preventing and treating blood clots; risk reduction for patients with coronary or peripheral artery disease
  • Januvia, for treating diabetes
  • Farxiga, for treating diabetes, heart failure and chronic kidney disease
  • Entresto, for treating heart failure
  • Enbrel, for treating rheumatoid arthritis, psoriasis and psoriatic arthritis
  • Imbruvica, for treating blood cancers
  • Stelara, for treating psoriasis, psoriatic arthritis, Crohn’s disease and ulcerative colitis
  • Fiasp/Novolog, for treating diabetes


These 10 drugs are among the highest costs in total spending in Medicare Part D. In fact, Medicare enrollees taking these drugs paid a collective $3.4 billion in out-of-pocket costs in 2022 to obtain them. Due to the high costs of these prescriptions, many Americans are forced to choose between paying for vital medications or food and other necessities.


What’s Next?

The Medicare Drug Price Negotiation Program is the Biden administration’s latest effort to combat rising health care costs. As such, Medicare drug price negotiation aims to lower out-of-pocket costs for millions of seniors and offer savings for taxpayers.


The first round of Medicare Part D drug negotiations will begin this year, with the new prices becoming effective in 2026. Over the next four years, Medicare plans to negotiate prices for up to 60 Part D and Part B drugs—and up to an additional 20 drugs every year after that.


Employers should continue to monitor health care trends, utilization and spending. Contact us today for more information.

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11 May, 2024
On April 29, 2024, the U.S. Department of Labor’s (DOL) Wage and Hour Division (WHD) published Field Assistance Bulletin (FAB) No. 2024-1 on the use of artificial intelligence (AI) in the workplace. The FAB follows a statement released by the White House announcing key AI-related actions following President Joe Biden’s executive order issued on Oct. 30, 2023, on establishing standards for AI safety and security. Guidance on AI-related Wage and Hour Risks Employers are increasingly using AI tools to generate timecards, set schedules, monitor performance, track employee hours and process payroll. As such, the FAB highlights certain compliance risks under the Fair Labor Standards Act (FLSA) for employers using these tools. These risks include: Tracking employee work time; Monitoring employee break and waiting time; Using location-based monitoring for individuals performing work at multiple geographic locations; Calculating employees’ regular rate of pay and overtime compensation; and Violating the FLSA’s antiretaliation provisions To aid employers in addressing these compliance risks, the WHD identifies recommended practices, including exercising proper human oversight, to help ensure that AI systems and tools do not violate the FLSA. Additional AI-related Guidance In addition to addressing FLSA compliance risks, the FAB also examines certain AI-related risks that may arise under other laws, including the Family and Medical Leave Act (FMLA), the Providing Urgent Protections for Nursing Mothers Act (PUMP Act) and the Employee Polygraph Protection Act (EPPA). For example, using AI tools to administer FMLA leave can create potential risks for violating the law’s certification requirements when determining whether an employee’s leave is FMLA-qualifying. Employer Action Items While FABs are not necessarily legally binding, they offer insight into how the DOL interprets laws it enforces and how agency officers will analyze workplace conditions and circumstances to enforce compliance.  Using AI systems for scheduling, timekeeping and calculating rates of pay and overtime may increase an employer’s risk under the FLSA. Therefore, employers should ensure that their AI systems and tools comply with all federal laws and regulations by examining potential legal and business risks associated with AI, implementing AI usage policies and establishing internal best practices.
30 Apr, 2024
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