The Centers for Medicare & Medicaid Services Aug. 29 announced that beginning in 2020 it will allow Medicare Part D plans to vary the formulary placement of a drug based on what condition the drug may treat. Today, if a health plan covers a drug, it must cover it for all approved indications unless a particular use is not covered under Part D generally. According to CMS, this flexibility will give plans greater negotiating leverage with drug manufacturers and reduce the prices they pay for drugs. For more information, see the CMS factsheet.

Related News Articles

Headline
The Centers for Medicare & Medicaid Services yesterday released a fact sheet for state and local governments seeking Medicare, Medicaid or Children’s…
Headline
Over 1,750 Medicare Part D prescription drug plans and Medicare Advantage plans with prescription drug coverage have applied to offer lower insulin costs…
Headline
The Government Accountability Office today named three new members to the Medicare Payment Advisory Commission through April 2023. They are: Wayne…
Headline
More than half of U.S. adults aged 70 and older have experienced a disruption in their medical care during the first month of social distancing for COVID-19,…
Headline
The AHA and other national hospital organizations today urged the Department of Health and Human Services and Centers for Medicare & Medicaid Services to…
Headline
The Medicare Hospital Insurance Trust Fund will have sufficient funds to pay full benefits until 2026, according to the latest annual report from the…