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CMS Unleashes Part D Drug Data

Author | Shield HealthCare
05/04/15  9:48 PM PST
State Medi-cal

Nexium Costs Program Most

The CMS dropped new data Thursday detailing the $103 billion that Medicare’s Part D prescription drug program spent in 2013. The agency said the release was part of the Obama administration’s plan to make the healthcare system more transparent.

The data show the names, locations and specialties of physicians and healthcare organizations who submitted drug claims to Medicare in fiscal 2013, as well as the names, costs and number of prescriptions for each individual drug.

Medicare’s traditional and private Medicare Advantage health plans often overshadow Part D, but the program is projected to absorb $76 billion of taxpayer money this year after accounting for premiums seniors pay, according to the Congressional Budget Office. That’s about 12% of all Medicare spending.

Officials said releasing the information—similar to what the CMS did with inpatient hospital charges, outpatient charges and payments to physicians—will give the public an opportunity to see how the government manages pharmaceuticals for seniors. The CMS is also encouraging health policy enthusiasts to dive into the data and offer their insight.

“We know there are many, many smart minds in this country,” Sean Cavanaugh, CMS deputy administrator and director of the Center for Medicare, said on a call with reporters. “We’re excited to unleash those minds and see what they find in our data.”

Dan Mendelson, CEO of Washington-based consulting firm Avalere Health and a former White House health director, said his group was pouring over the data and was happy the government is unlocking more information. “It will stimulate a lot of discussions about pharmaceuticals between patients and physicians that will ultimately prove to be valuable,” Mendelson said.

The data are based on 35.7 million Part D beneficiaries from 2013. Almost two-thirds of that total was in stand-alone prescription drug plans, and the other third had their Part D benefits through their Medicare Advantage health plan.

Original article authored by Bob Herman of Modern Healthcare on April 30, 2015. Read the Full Article here.