Legislation & Regulation

On May 29, AMCP released the following statement, which expresses concerns about the Illinois General Assembly's Healthcare protection Act (HB 5395). Passed on May 25, the bill restricts managed care pharmacists' ability to manage prescription drug benefits for millions of Illinoisans covered under the state’s Medicaid program, state employee group insurance, and fully insured commercial plans.

On Feb. 29, 2024, the Centers for Medicare and Medicaid Services (CMS) issued The Medicare Advantage and Prescription Drug Programs: Part C and Part D Medicare Prescription Payment Plan Model Documents. AMCP submitted comments in response to this Model Documents on April 29, 2024.

On Feb. 15, 2024, the Centers for Medicare and Medicaid Services (CMS) issued the Medicare Prescription Payment Plan: Draft Part Two Guidance and a Fact Sheet to provide guidance on education and outreach requirements for the Medicare Prescription Payment Plan (M3P), which was established by the Inflation Reduction Act (IRA). AMCP submitted comments in response to this Guidance on March 15, 2024.

In a March 5, 2024 press release, the Department of Health & Human Services (HHS) expressed intent to issue guidance to encourage Medicare Advantage (MA) and Part D plans to relax or remove prior authorization requirements and other utilization management strategies. On March 6, 2024, CMS issued a memo encouraging MA and Part D plans to relax or remove prior authorization requirements in response to the Change Healthcare cyberatack. AMCP sent a letter in response to this guidance on March 8, 2024.