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
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…
Headline
An analysis by KFF released Jan. 28 found that Medicare Advantage insurers made nearly 50 million prior authorization determinations in 2023. The finding…