ASHP Highlights IRA Concerns for CMS

ASHP is pushing the Centers for Medicare & Medicaid Services (CMS) to change course on harmful pricing framework for the Inflation Reduction Act (IRA) that threatens to increase costs for providers.

ASHP submitted comments on the CMS proposed rule governing policy and technical changes for Medicare Part D, Medicare Advantage, and elder care programs for 2026. The proposed rule, issued at the end of the Biden administration, covers a range of issues, including coverage of GLP-1s, streamlining of prior authorization requirements, guardrails for artificial intelligence development, and implementation of certain provisions of the IRA.

ASHP’s comments focused on CMS’s proposed implementation of the IRA’s negotiated pricing framework. Despite aggressive advocacy from ASHP and other hospital and pharmacy organizations, CMS has moved forward with a retrospective rebate approach to Medicare drug price discounts that threatens to increase costs for providers, undermining the value of the IRA’s drug pricing provisions. ASHP has requested that CMS pause its implementation and allow the new administration to reassess the policy.

ASHP anticipates that CMS will publish a revision of the proposed rule that reflects the Trump administration’s policy priorities. ASHP will update members about any new developments. In the interim, we will continue proactive outreach with new CMS officials in the incoming administration to address our serious concerns with the agency’s approach to IRA implementation. Questions or concerns about the proposed rule or the IRA should be addressed to Jillanne Schulte Wall, senior director of health and regulatory policy.