Mark N. Painter, CPMA, presented “2025 Medicare Part D Changes: An Overview” for the Grand Rounds in Urology audience in October 2024.
How to cite: Painter, Mark N. “2025 Medicare Part D Changes: An Overview.” October 2024. Accessed Oct 2024 . https://grandroundsinurology.com/2025-medicare-part-d-changes-an-overview/
2025 Medicare Part D Changes: An Overview – Summary
Mark N. Painter, CPMA, Managing Partner, Consulting LLC, CEO, PRS Urology Service Corporation, Vice President of Coding and Reimbursement Information and CEO Relative Value Studies, Inc. reviews upcoming 2025 Medicare Part D changes. Mark begins by sharing an overview of the forthcoming changes and what they aim to achieve. He then goes into detail of each new update to Medicare Part D, including the reduction of the maximum out-of-pocket expenditure from $3,500.00 in 2024 to $2,000.00 in 2025, the Medicare Prescription Payment Plan (MPPP) or “smoothing option”, and “Likely to Benefit Letter” and how these can affect different patients, including those that are eligible for grants or subsidies.
This 13-minute discussion concludes with Mark emphasizing that education for both patients and urology practices on these updates is the best way to ensure successful adoption of the upcoming Medicare Part D changes and a reminder that Open Enrollment begins on October 15, 2024, and runs through December 7, 2024.
ABOUT THE AUTHOR
Mark N. Painter is a managing partner of PRS Consulting LLC, the CEO of PRS Urology Service Corporation, the Vice President of Coding and Reimbursement Information for Physician Reimbursement Systems, Inc., and CEO of Relative Value Studies, Inc. Since co-founding PRS in 1989, Mr. Painter has served as the primary coding resource for the PRS products currently produced and marketed in conjunction with 9 National Specialty Organizations including hotlines, coding manuals, and quick reference tools, the internet-based application codingtoday.com, and seminars. He has lectured to a variety of groups concerned with healthcare reimbursement. Mr. Painter’s extensive knowledge of physician documentation, as well as coding and reimbursement issues, has allowed him to assist insurance companies, physicians and their staff members, legal counsel, actuaries, specialty societies, consultants, and the medical industry on a daily basis. Mr. Painter has been the lead for the company on multiple corporate/physician integrity agreements serving as the Independent Review Organization (IRO), and has successfully overseen the review and continued participation in Medicare of several practices from multiple specialties. Mr. Painter has been commended for his education and direction for appropriate documentation and coding by multiple Medicare medical directors with whom he has shared the podium during national and regional medical meetings. He serves as an expert in legal counsel for bio device companies, medical directors, and pharmaceuticals.
