HAP's Latest News

CMS Could Lower Medicare Part B Premiums for 2023

Final decision pending this fall after lower-than-expected costs for Alzheimer drug

May 31, 2022

Medicare Part B beneficiaries could see lower premiums during 2023 due to lower-than-expected costs for Biogen’s Alzheimer medication, Aduhelm, HHS recently announced.

In a statement last week, HHS Secretary Xavier Becerra instructed CMS to reassess Medicare Part B premiums for next year and said it is expected that the 2023 premium will be lower than 2022. The final determination will be made later this fall.

The 2022 Medicare Part B monthly premium of $170.10 increased 14.5 percent from 2021, largely due to rising health care prices and utilization, Congressional action, and potential costs from Aduhelm, HHS said.

“Due to changes in the cost of Aduhelm and coverage since the premium was established, CMS recommends that the lower-than-anticipated spending in 2022 be incorporated into the 2023 Part B premium determination,” CMS Administrator Chiquita Brooks-LaSure said in a statement.

Here’s’ what you need to know:

  • Rationale for 2023 reassessment:  About half of the 2022 premium increase came from anticipated costs related to Aduhelm due to the drug’s average price of $56,000 per year. After the 2022 Part B premiums were announced, Biogen reduced the price to an average of $26,200, and CMS narrowed the national coverage for the drug, resulting in additional cost-savings.
  • What’s covered:  Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A.
  • Next steps:  The 2023 Medicare Part B premium will be announced in the fall, following a review of 2022 spending, utilization, and savings related to Aduhelm.
  • For questions:  CMS encourages people with Medicare to check their eligibility to receive financial assistance through Medicare Savings Programs. Learn more by calling 1-800-MEDICARE or reviewing online resources.

Additional analysis about the Medicare Part B rates is available online.

 



+