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
A KFF analysis released Jan. 28 found that Medicare Advantage insurers made nearly 53 million prior authorization determinations in 2024, an increase…
Headline
The Centers for Medicare & Medicaid Services Jan. 26 released proposed changes to Medicare Advantage plan capitation rates and Part D payment policies for…
Headline
The AHA Jan. 26 expressed support and provided its perspective on certain provisions within the Centers for Medicare & Medicaid Services’ proposed…
Headline
The comment period for the Centers for Medicare & Medicaid Services' proposed rule for policies governing the Medicare Advantage and Part D programs for…
Headline
The Medicare Payment Advisory Commission Jan. 15 voted to recommend that Congress update Medicare payment rates for hospital inpatient and outpatient services…
Headline
UnitedHealth Group announced Jan. 14 that it launched a six-month pilot program to reduce Medicare Advantage payment processing times by half for rural…