CMS Releases Finalized Medicare Advantage & Part D Rule

On May 16, the Centers for Medicare & Medicaid Services (CMS) released their final rule titled “Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses.” Highlights from this final rule include:

• Reversal from the outlined proposed rule that would have allowed for significant change to the Medicare Part D six protected classes and coverage of these important therapies.
• Part D plan sponsors will be required to implement an electronic real-time benefit tool (RTBT) with the goal of increasing price transparency. This tool seeks to be capable of integrating with at least one prescriber's electronic prescribing system or electronic health record.

The ACCC policy team will continue to analyze this rule and provide a more detailed analysis at a later date.

Read the CMS final rule here.

Posted 5/17/2019