Executive Order 14087 · Signed Oct 14, 2022

87 FR 63399 · Published Oct 19, 2022 · Effective on signing

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Lowering Prescription Drug Costs for Americans

prescription drug costsMedicare and Medicaidhealth care payment reformdrug pricing policy

Signed by President Joseph R. Biden Jr.

The order directs HHS to consider and test new Medicare and Medicaid payment models designed to lower prescription drug costs and improve access to innovative therapies, building on the Inflation Reduction Act signed two months earlier.

Establishes a 90-day deadline for HHS to report on which models it has selected and lays out a plan to test them, extending the administration's drug-pricing agenda through the Innovation Center's existing authorities.

What this order does

What it orders

The order directs the Secretary of Health and Human Services to consider selecting new health care payment and delivery models for testing through the Center for Medicare and Medicaid Innovation. The models must meet existing statutory criteria and should aim to lower drug costs, reduce cost-sharing for commonly used drugs, promote access to innovative therapies, and support value-based payment for Medicare and Medicaid beneficiaries. The Secretary must submit a report within 90 days describing any selected models and a timeline for testing them, then take action to implement the models described.

The order does not itself create any new drug pricing rules, mandates, or patient benefits; all actual impact depends on which models HHS selects and subsequently tests. Standard general-provisions clauses limit the order to actions consistent with applicable law and available appropriations, and expressly state it creates no enforceable rights for any party.

Who it affects

Medicare and Medicaid beneficiaries who may eventually see lower drug costs or reduced cost-sharing if new payment models are adopted. Pharmaceutical companies and health care providers whose reimbursement arrangements could change under any models HHS ultimately selects and tests.

Why it matters

Any patient benefit depends entirely on future HHS decisions about which models to select and test — the order itself changes no drug prices or coverage rules. Beneficiaries and drug makers will not see direct effects until HHS acts on its 90-day report and begins model testing.

What must happen and when

How the order is supposed to work

The Secretary of HHS reviews potential payment and delivery models under the Innovation Center's existing statutory authority (42 U.S.C. 1315a(b)(2)), selects candidates, and submits a report to the Assistant to the President for Domestic Policy within 90 days. That report must describe each selected model and include a testing plan with a timeline. After submission, HHS takes steps to actually run the selected models. There is no independent enforcement mechanism; follow-through depends on HHS discretion and appropriations availability.

Actions and deadlines

  • Submit a report to the Assistant to the President for Domestic Policy enumerating selected Innovation Center payment and delivery models and a testing planWithin 90 days of signing
  • Take appropriate actions to test health care payment and delivery models described in the reportNo deadline specified

Agencies directed to act

Department of Health and Human ServicesCenter for Medicare and Medicaid Innovation

Authority and reach

Authorities cited

Article II

Constitutional grant of executive power to the President.

42 U.S.C. 1315a(b)(2)

Statutory criteria governing selection of models for testing by the Center for Medicare and Medicaid Innovation.

Executive Order

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