On March 1, 2019, AMCP provided comments to CMS in response to its 2020 for Medicare Part D Call Letter. AMCP offered comments on the following sections of the notice; Part D Benefit Parameters for Non-Defined Standard Plans; Formulary Submissions; Medication Therapy Management (MTM); and Part D Mail Order Auto-Ship Modifications.
On January 30, 2019, CMS published an Advanced Notice of Methodological Changes for Calendar Year 2020 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies and 2020 Draft Call Letter. The summary outlines proposals in the draft Call Letter.
On January 30, 2019, CMS issued its draft Part D Payment Policies and 2020 Draft Call Letter.
The draft Call Letter outlines payment amounts for beneficiary cost sharing, risk corridors for Part C and Part D plans, and beneficiary payments for calendar year 2020. Many of the draft provisions for the 2020 plan year revolve around opioids and CMS’s effort to ensure beneficiaries are receiving appropriate pain management therapy. CMS also proposes numerous updates, changes and potential new measure concepts for the Star Ratings Program. CMS is also considering changing policies and is accepting comments relating to its tier composition policy for generics and specialty medications in Part D.
On Nov 1, 2018 CMS issued a proposed rule that updates Medicare Advantage (MA) and Medicare Part D Programs. The proposed rule would allow MA plans to offer “additional telehealth benefits”, makes changes to dual-eligible special needs plans, would allow Part D plans to request standardized extracts of Medicare claims data about its plan enrollees, and proposes enhancements to star ratings.
AMCP submitted comments to CMS in response to its proposed rule for technical changes to the Medicare Prescription Drug Benefit Program. AMCP offered comments on the following areas of the proposed rule: drug management programs, Medication Therapy Management, benefit design & utilization management, health information technology & data interoperability, and fraud, waste, & abuse.
On November 16th, 2017, CMS released a much anticipated proposed rule that amends regulations for Medicare Part C and Medicare Part D to implement provisions of the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act. The proposed rule also makes changes to improve program quality, accessibility, and affordability and also adopts the updated NCPDP script standard for electronic prescribing.