It felt like a relatively quiet week. Or did I just completely jinx today?

Caught my Eye

Ask Me Anything. FAQs released on the 340B Model Pilot program. This is the program where manufacturers with 2026 Medicare negotiated drugs can move to a rebate program for 340B for the negotiated drugs.

Manufacturers that submit plans by September 15 will get approval by October 15 and then they must communicate the information to covered entities 60 days before the implementation date (presumably January 1.) All a little close for comfort.

Wrong Not Wiser? As much fun as it is reading CMS.gov, a New York Times article is easier to digest. Here’s an article (gift link) on the Wasteful and Inappropriate Service Reduction (WISeR) model where Medicare is playing with a demonstration that will introduce prior authorization into Traditional Medicare. It might be the right call, but it sort of feels wrong given the issues that Medicare Advantage beneficiaries have with prior authorization.

Where in the World. NYT article (gift link) on where drugs are made.

Reviewing the Fundamentals – Medicare Prescription Payment Plan

The Medicare Prescription Payment Plan (MPPP) allows Part D beneficiaries to spread out costs over the course of the year rather than paying at the point of sale. It works well for beneficiaries that have higher annual out-of-pocket costs and/or inconsistent higher costs throughout the year.

The MPPP began in 2025 and enrollment appears to be slow going. Like maybe 200k people. We don’t know a lot about who is enrolled and how it is going so any scrap of information is appreciated – including this new report from IQVIA.

I try and be a glass half full person, but I know that some look at the charts in this and see a program that appears to be failing with a small % of claims being processed as part of the MPPP. I find myself shrugging – yes, it seems low but what should it be? I mean even if all the people who would benefit from the program (< 2 million) were to enroll, that is a small segment of the Medicare population.  

Here is what I’m taking away from this report and my work on this issue over the last few months (including a report coming out in a few weeks), the MPPP is a good idea but it has been slow in rolling out. If they even know about it, beneficiaries are confused about the MPPP and how it works for them. Plans are not motivated to share information about it and the Centers for Medicare & Medicaid Services doesn’t seem to be into it either. What might be encouraging some people to enroll is patient assistance programs that, instead of signing people up for their programs, are saying look at MPPP first. MPPP use by therapeutic area gave me hope. I think the MPPP will be a slow burn – maybe 400k next year and building from there. Or maybe that’s just optimism?

For the Files

PAN Foundation resource on the MPPP