Medicare Part D: Closing the Coverage Gap

Signed into law on February 9, 2018, the Bipartisan Budget Act (BBA) of 2018 entails significant adjustments to consumer spending under the Medicare Part D prescription drug program. Beginning in 2019, the period of out-of-pocket expenses in Medicare, known colloquially as the coverage gap or donut hole, will be fully covered for beneficiaries. By requiring higher payments from pharmaceutical manufacturers, the BBA of 2018 accelerates the original time frame laid forth in the Affordable Care Act for closure in 2020. While the long-term effects are open to speculation, industry stakeholders will want to familiarize themselves with the components of this act to better prepare for its potential implications.

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Robert Blank
Managing Consultant

Robert Blank is a managing consultant at EVERSANA, working extensively in revenue management software solutions for the pharmaceutical and medical device industries. His expertise includes Medicaid and Managed Care rebates, chargebacks, and membership management. He has developed custom client solutions around value based contracting, formulary validation, discount reallocation, and the 340B Drug Pricing Program. In […]