The Centers for Medicare & Medicaid Services (CMS) issued its final rule with updates to Medicare Advantage (MA) and Part D.
According to CMS, the final rule will save Medicare beneficiaries money on prescription drugs by implementing policies favored by the Administration to lower out-of-pocket drug costs such as reducing the maximum amount that low income beneficiaries pay for biosimilars and increasing the number of pharmacy options that beneficiaries have by clarifying the “any willing provider” requirement. The final rule implements provisions included in the Comprehensive Addiction and Recovery Act of 2016 (CARA) to combat the opioid epidemic. Policies include establishing a framework that allows Part D sponsors to implement drug management programs, called lock-in programs, while ensuring access to drugs for beneficiaries with certain chronic conditions.
The final rule also announces CMS’ intent to adopt NCPDP SCRIPT Standard, Version 2017071 beginning on January 1, 2020.
Read more of the draft notice to be published in the Federal Register.