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Program Overview

The IRA University is an eLearning program designed to give learners a deeper understanding of the history, structure, and details of the implementation of this landmark legislation. This program will review the key components of the Medicare Part D Redesign, Prescription Payment Plan, and Drug Price Negotiation Program. Participants will gain insights into how these reforms impact the broader healthcare ecosystem and its key players across the industry.  

Module 1: Overview of the IRA

This module will include an introduction to the historical context and legislative foundation of the Inflation Reduction Act (IRA) and its significance in the context of the US healthcare system. It will review its key provisions, such as the Medicare Part D redesign, drug price negotiation provisions and timeline, and Part B changes. Additionally, participants will gain insights into the implications of the IRA on managed care, pharmaceutical innovation, and the broader healthcare ecosystem.  

• Describe the legislative and regulatory foundation of the Inflation Reduction Act. 

• Discuss the significance of the IRA in the context of the US healthcare system. 

• Identify the key provisions of the IRA that impact managed care, including the Medicare Part D Redesign, drug price negotiation, and Part B changes. 

• Recognize the potential impacts of the IRA on drug development and pricing, formulary management, and utilization tools. 

Module 2: Part D Redesign

This module will examine the structure, selection process, and negotiation timeline of the Medicare Drug Price Negotiation Program under the Inflation Reduction Act (IRA). Learners will review the program's goals and anticipated impact on the healthcare system, as well as notable exceptions and special cases within the negotiation framework. Additionally, this module will discuss the implications for key healthcare groups such as payers, manufacturers, and pharmacy benefit teams, and assess how the program influences point-of-sale operations and patient access to selected medications.    

• Discuss the structure, drug selection process, and negotiation timeline under the IRA.  

• Review the goals of the Medicare Drug Price Negotiation Program and its anticipated impact on the healthcare system.  

• Identify exceptions and special cases in the negotiation process.  

• Recognize the implications for manufacturers, payers, and pharmacy benefit teams.  

• Describe the impact on operations at the point-of-sale for patients and medication access for selected drugs. 

Module 3: Medicare Prescription Payment Plan

This module provides a comprehensive overview of the regulatory framework of the Medicare Prescription Payment Plan as well as CMS rules for election, billing, communications, and reporting. It will also examine eligibility requirements, the process for opting in and out of the program, and the responsibilities of plan sponsors and pharmacies in ensuring compliance and participant support.  

• Explain the provisions of the Medicare Prescription Payment Plan and how it impacts Medicare Part D beneficiaries 

• Describe eligibility, payment calculation, and election process requirements 

• Discuss the role of community pharmacists in administering the Medicare Prescription Payment Plan benefit 

Module 4: Drug price negotiation

This module will discuss the requirements of the Medicare Part D Redesign, such as the expansion of the Low-Income Subsidy program, an annual out-of-pocket cap, and several other measures aimed at improving the affordability and predictability of drug costs for enrollees. It will also dive into the restructured benefit changes, which include the annual deductible, coverage gap, and initial and catastrophic coverage. Additionally, learners will gain insights into the potential impacts of the Medicare Part D Redesign on plan offerings and pricing strategies.   

• Describe the requirements of the Medicare Part D Redesign. 

• Explain the restructured benefit phases of Medicare Part D, including the updates to the annual deductible, coverage gap, and the initial and catastrophic coverage.  

• Review the impact of the IRA’s Medicare Part D redesign on plan offerings and pricing strategies.