CMS rule guarantees Part D continuity
CMS has ruled that when Medicare Part D plans impose newrestrictions or eliminate a drug from their formularies, they mustcontinue coverage for the remainder of the year on anybeneficiaries who were already taking the medication.
CMS has ruled that when Medicare Part D plans impose new restrictions or eliminate a drug from their formularies, they must continue coverage for the remainder of the year on any beneficiaries who were already taking the medication. There are some exceptions to the continuity-of-coverage rule, such as the removal of a formulary drug found to be unsafe or the addition of a low-cost generic drug that becomes available. Congressional Democrats and a few Republicans had criticized as unfair that drug plans can change formularies at will but most beneficiaries are locked into a plan for 12 months.
How Mark Cuban Cost Plus Drug Company Is Approaching Drug Pricing Transparency
October 14th 2024Erin Albert, vice president of pharmacy relations and chief privacy officer at Mark Cuban Cost Plus Drug Company, PBC, discussed drug pricing and what her company is doing to revolutionize transparency.
