What the Inflation Reduction Act of 2022 (IRA) means for your practice


On August 16, President Biden signed into law the Inflation Reduction Act of 2022 (IRA), culminating some two decades of Democratic efforts to enact Medicare prescription drug price negotiation.

We've included some key provisions, as well as a timeline and some highlights in the bill around biosimilars that could impact your practice.

Key healthcare provisions include:

  • The Medicare drug price negotiation requirements for drugs in Part D and Part B (taking effect in 2026 and 2028, respectively, though implementing rulemaking/guidance could come out as early as this year);
  • A redesign of Medicare Part D, including a new $2,000 annual cap on beneficiary out-of-pocket (OOP) costs, as well as a redistribution of the financial responsibilities for the Part D benefit among the drug manufacturers, Part D plans, and Medicare;
  • A $35 patient OOP cap on insulin in Medicare; and
  • A three-year extension of the previously passed temporary enhancements to Affordable Care Act premium subsidies, which significantly reduces premiums in ACA Marketplace plans, particularly for low-income and rural residents in areas with high insurance costs.
  • For qualifying biosimilar biological products having an ASP that is lower than their reference biological product’s ASP, the IRA authorizes HHS to increase the Part B add-on payment temporarily for 5 years, from 6% to 8% of the reference product’s ASP, beginning on 10/1/22.

You can read the entire Inflation Reduction Act of 2022 here.

Inflation Reduction Act Timeline 

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