CMS OIG Report:  A nationwide audit of Medicare Part C and Part D data from 2018 and 2019 revealed a staggering 3 billion prescription drug events (PDEs), representing $234 billion in total drug plan payments. 

Imagine the impact of approximately 80% of the 3 billion annual Medicare Part C and D prescription drug events (PDEs) being paid for by cash-paying customers.

Imagine the estimated 88,000 pharmacies across the U.S. being paid ‘in cash’ for 2.4 billion Medicare Part C and D PDEs. Higher profitability. No Part D or Part C plan middlemen. No claims filing. No rejected claims.

Imagine The Leviticus 25 Plan that generates $36.568 billion federal budget surpluses annually during each of the first five years of activation (2026-2030), and pays for itself entirely over 10-15 years.

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KFF: A Current Snapshot of the Medicare Part D Prescription Drug Benefit

Juliette Cubanski
Published: Oct 09, 2024
KFF – The independent source for health policy research, polling, and news.
Excerpt:

Key Takeaways

• In 2024, 53 million of the 67 million Medicare beneficiaries are enrolled in Medicare Part D plans, including employer-only group plans; of the total, 57% are enrolled in MA-PDs and 43% are enrolled in stand-alone PDPs. As of June 2024, 3 million Part D enrollees receive premium and cost-sharing assistance through the LIS program.
• The Congressional Budget Office (CBO) estimates that spending on Part D benefits will total $137 billion in 2025, representing 15% of net total Medicare spending. Funding for Part D comes from general revenues (75%), beneficiary premiums (15%), and state contributions (13%).
• Medicare’s aggregate reinsurance payments to Part D plans are projected to account for 17% of total Part D spending in 2025, a substantial reduction from 2024. This change reflects the reduction in Medicare’s liability for catastrophic drug costs from 80% in 2024 to 20% for brands and 40% for generics in 2025.

Part D Spending

In its June 2024 Medicare baseline projections, the Congressional Budget Office (CBO) estimated that spending on Part D benefits would total $137 billion in 2025, representing 15% of total Medicare outlays (net of offsetting receipts from premiums and state transfers).

However, based on actual bid data submitted by Part D plans for coverage in 2025, CBO estimates higher federal spending on Part D of between $10 billion and $20 billion relative to its initial projections for 2025. CBO also estimates that Medicare will spend an additional $5 billion in 2025 on subsidies to plans that are participating in the Part D premium stabilization demonstration.

Payments to Plans

For 2025, Medicare’s actuaries estimate that Part D plans will receive direct subsidy payments averaging $1,417 per enrollee overall, $1,504 for enrollees receiving the LIS, and $445 in reinsurance payments for high-cost enrollees; employers are expected to receive, on average, $640 for retirees in employer-subsidy plans. Part D plans also receive additional risk-adjusted payments based on the health status of their enrollees, and plans’ potential total losses or gains are limited by risk-sharing arrangements with the federal government (“risk corridors”).

As of 2025, Medicare’s reinsurance payments to plans for total spending incurred by Part D enrollees above the catastrophic coverage threshold will subsidize 20% of brand-name drug spending and 40% of generic drug spending, down from 80% in previous years, due to a provision in the Inflation Reduction Act. With this change in effect, Medicare’s aggregate reinsurance payments to Part D plans are projected to account for 17% of total Part D spending in 2025, based on KFF analysis of data from the 2024 Medicare Trustees report. This is a substantial reduction from 2024, when reinsurance spending had grown to account for close to half of total Part D spending (46%) (Figure 7). Moving forward, the largest portion of total Part D spending will be accounted for by direct subsidy payments to plans (54% of total spending in 2025).

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The Leviticus 25 Plan is a dynamic economic initiative providing direct liquidity benefits for American families, while at the same time scaling back the role of government in managing and controlling the affairs of citizens.  It is a comprehensive plan with long-term economic and social benefits for citizens and government.

The inspiration for this plan is based upon Biblical principles set forth in the Book of Leviticus, principles tendering direct economic liberties to the people.

The Leviticus 25 Plan – An Economic Acceleration Plan for America

$95,000 per U.S. citizen –Leviticus 25 Plan 2026 (32660 downloads )