AMCP webinar that discussed the midterm elections, the party split for the 116th Congress, and what may or may not come up as health care priorities for federal and state legislators.
On November 26, 2018, CMS issued a new proposed rule outlining potential policies that are intended to lower the cost of prescription drugs. Major Provisions in the proposed rule include; Providing Part D Prescription Drug Plan (PDP) flexibility to negotiate discounts for drugs in protected classes; Utilizing Real Time Benefits Tools (RTBT) in the Part D Program to increase drug price transparency at the point of prescribing; Codifying a policy to allow step therapy in Medicare Advantage for Part B Drugs; Amending regulations related to the Part D Explanation of Benefits (EOB) that plans send to beneficiaries to include drug pricing information and lower cost alternatives; Implementing a statutory provision prohibiting the use of gag clauses in pharmacy contracts; Considering a policy that would re-define negotiated price as the baseline, or lowest possible, payment to a pharmacy in future plan years as early as 2020.
AMCP webinar that reviewed the major provisions contained in a recently released advanced notice of proposed rulemaking from CMS on the International Drug Pricing Index for Part B drugs and a recently proposed rule on the Medicare Advantage and Part D Program.
AMCP summarizes the final 2019 CMS Physician Fee Schedule. The final rule includes provisions relating to Substance Use-Disorder (SUD) prevention and includes an interim final rule that would allow telehealth service treatment for a SUD to be provided at the home of an individual for the first time starting in July, 2019.
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.