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 AHA July 8 wrote in opposition to the “Patient Access to Higher Quality Health Care Act” (H.R. 4002), which would repeal current law banning the creation…
Headline
The AHA July 3 released the Health Care Plan Accountability Update for the second quarter of 2025. The update covers the latest developments in Medicare…
Headline
The Departments of Justice and Health and Human Services today announced the creation of the DOJ-HHS False Claims Act Working Group to combat health care fraud…
Headline
The Centers for Medicare & Medicaid Services today announced it has identified a fraud scheme targeting Medicare providers and suppliers. CMS said scammers…
Headline
A report released June 17 by NORC at the University of Chicago, commissioned by the Coalition to Strengthen America’s Healthcare, found that patients enrolled…
Headline
The Centers for Medicare and Medicaid Services May 30 released a notice requesting comments on a proposed Medicare Advantage service level data collection…