CMS releases final rule for Medicare Advantage, prescription drug plans
The Centers for Medicare & Medicaid Services today finalized additional provisions for the Medicare Advantage and Part D prescription drug programs beginning in 2022.
The rule permits a “preferred” specialty tier for Part D, which will provide a lower cost-sharing amount than the other specialty tier by allowing Part D plans more negotiating power with manufacturers.
The rule also codifies updates to Star Ratings for Part D plans and requires Part D plans to disclose pharmacy performance measures to CMS. Beginning in 2023, plans must provide a real-time benefit tool to help enrollees find the most cost-effective prescription drugs for their needs.
Related News Articles
Headline
Leaders from the Centers for Medicare & Medicaid Services at the 2025 AHA Annual Membership Meeting May 5 discussed issues on the agency’s agenda in a…
Headline
The AHA April 30 released a report highlighting how hospitals and health systems continue to experience significant financial headwinds that can challenge…
News
The Centers for Medicare & Medicaid Services April 7 released finalized payment rates for calendar year 2026 Medicare Advantage and Part D plans. Payments…
Headline
The Centers for Medicare & Medicaid Services April 4 finalized changes to the Medicare Advantage and prescription drug programs for contract year 2026. The…
Headline
The AHA March 11 shared ways Congress could better support patient access to post-acute care in comments for a hearing held by the House Committee on Ways and…
Headline
A new AHA report highlights how certain practices by Medicare Advantage plans are increasing rural hospitals' vulnerabilities and threatening access to care in…