AMCP Issues Statement on CMS’s 2016 Call Letter for Medicare Programs


Alexandria, Va., February 23, 2015 — The Academy today issued the following statement by AMCP CEO Edith A. Rosato, RPh, IOM, on the Centers for Medicare and Medicaid Services’ recently released Advance Notice of Methodological Changes for Calendar Year 2016 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies and 2016 Call Letter:

"We are pleased to see that CMS will not take any significant action on preferred pharmacy networks, and will allow Medicare Part D plans to continue to design effective pharmacy networks that save consumers and the government money. This position is consistent with AMCP’s perspective that preferred pharmacy networks promote market competition by serving as a tool to encourage affordable access to medications through negotiations between Part D plans and pharmacies. 

As findings from a recent study indicate, the vast majority of Medicare beneficiaries have access to preferred cost-sharing, and AMCP supports CMS’ position to provide beneficiaries with more information about preferred cost-sharing, identify the outlier Part D plans not providing sufficient access to preferred cost-sharing and work with these plans to ensure appropriate access. This is a better alternative to making major changes to requirements around pharmacy networks that could potentially disrupt the success of the Medicare Part D program."