CMS to allow Part D plans to use new formulary tool beginning in 2020
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 Trump administration announced a trade agreement with the U.K. Dec. 1 on pharmaceuticals that exempts U.K. drug products from Section 232 tariffs. In…
Headline
The House Dec. 1 passed the Hospital Inpatient Services Modernization Act (H.R. 4313), legislation extending certain Medicare waivers authorizing the hospital-…
Headline
The Centers for Medicare & Medicaid Services announced Dec. 1 that it intends to expand the Inpatient Rehabilitation Facility Review Choice Demonstration…
Headline
The Centers for Medicare & Medicaid Services Nov. 25 announced lower prices for 15 Medicare Part D drugs selected for the second cycle of negotiations…
Headline
The Centers for Medicare & Medicaid Services Nov. 25 issued a proposed rule for policies governing the Medicare Advantage and Part D programs for 2027. CMS…
Headline
The Centers for Medicare & Medicaid Services released an updated notice Nov. 20 on the processing of Medicare provider claims impacted by the government…