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
Perspective
Few patient populations are more vulnerable to the shifting winds around health care today than Medicare beneficiaries who need specialized, high-acuity and…
Headline
The Centers for Medicare & Medicaid Services April 6 released the Medicare Advantage and Part D Rate Announcement for calendar year 2027. The rate…
Headline
The Centers for Medicare & Medicaid Services April 2 released a final rule on policy and technical changes to Medicare Advantage, the Medicare Prescription…
Headline
The Centers for Medicare & Medicaid Services March 30 announced that C2C Innovative Solutions will replace Maximus in reviewing and processing appeals of…
Headline
CMS accepting comments on data collection requirements for Medicare Advantage plans, Part D sponsors
The Centers for Medicare & Medicaid Services is seeking comments by May 11 on its proposed revisions to data reporting requirements for Medicare Advantage…
Headline
The Joint Economic Committee March 10 released a report that found Medicare Part B premiums rose last year due to Medicare Advantage overpayments. The…