AMCP opposes attempts to erode the Employee Retirement Income Security Act (ERISA) and Medicare Part D preemption. AMCP believes that the certainty that comes with a single uniform federal standard ensures that plans subject to these laws are better able to provide access to needed medications regardless of where the patient lives or works.
AMCP supports a wide range of measures that strike a balance between market-oriented principles and prudent regulations. Pharmacy benefit managers (PBMs) help facilitate patient access to medication at an affordable price.
On November 24, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule titled “Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2025; Updating Section 1332 Waiver Public Notice Procedures; Medicaid; Consumer Operated and Oriented Plan Program; and Basic Health Program”. This rule lays out standards for health insurance issuers, Affordable Care Act (ACA) insurance Marketplaces, and other relevant entities. AMCP submitted comments in response to this rule on January 8, 2024.
On November 15, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule titled “Medicare Program; Contract Year 2025 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Health Information Technology Standards and Implementation Specifications”. This rule touches on a variety of topics, including behavioral health specialties, criteria for Special Supplemental Benefits for the Chronically Ill, mid-year notification of availability of supplemental benefits, agent/broker compensation, health equity analysis of utilization management, validation of Part C and D reporting requirements, appeal rights for terminating coverage for non-hospital provider services, midyear substitution of biosimilars, dual-eligible enrollment periods, out-of-network cost-sharing for D-SNP PPOs, and MA RADV appeal regulations. AMCP submitted comments in response to this rule on January 5, 2024.
Partnership Forum: Participants discussed how digital therapeutics with web and designed based applications are emerging as a means to treat conditions by engaging people to improve health and wellness.
This sponsored webinar focuses on the burden of Major Depressive Disorder (MDD) and the impact of an atypical antipsychotic approved for the adjunctive treatment of MDD.