Identifying 340B Units to Recoup Inflation Rebates for Part B Drugs in Medicare Advantage

OBJECTIVE

To help address rising costs, the Inflation Reduction Act requires drug manufacturers to pay rebates when the price of an eligible Part B drug rises faster than inflation. While CMS began implementing this program in Medicare Fee-for-Service, it has not done so in Medicare Advantage (MA), citing "operational considerations". Such considerations may include difficulties with using the MA encounter data to identify which units of Part B drugs were purchased at a 340B discount price. Cost savings from inflation rebates for Part B drugs furnished in MA could be significant, especially considering that MA accounts for the majority of Medicare enrollment. This evaluation will determine the extent to which MA companies collect, store, and report 340B information on Part B drugs furnished in MA. Further, we will estimate the potential cost savings of recouping inflation rebates on eligible Part B drugs furnished in MA.

TIMELINE

• October 15, 2025
  Announced
• Today
  Office of Evaluation and Inspections In-Progress
• Est FY2027
  Estimated Fiscal Year for Project Completion

---