Trump’s Last-Minute Medicare Part D Rule Could Stand
On Jan. 19, the last full day of the Trump administration, CMS finalized a grab-bag rule that includes several drug pricing components. Experts tell AIS Health that the rule could tie the Biden administration to aspects of the Trump administration’s drug pricing agenda.
One requires Medicare Part D plans to offer a consumer-facing real-time benefit tool (RTBT) that grants enrollees instant formulary and benefit information, including an accurate estimate of their point-of-sale cost sharing. Another allows Part D plan sponsors to implement a second formulary tier for specialty drugs with a lower cost-sharing amount than their existing specialty tier beginning Jan. 1, 2022. The regulation also requires plans to report their internal, qualitative pharmacy evaluation data to CMS. Other notable elements of the rule include new requirements to address opioid overprescribing and misuse.
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Lauren Flynn Kelly Executive Editor, AIS Health, and Managing Editor, Radar on Medicare Advantage
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Angela Maas Managing Editor, Radar on Specialty Pharmacy and Spotlight on Market Access
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Leslie Small Managing Editor, Health Plan Weekly and Radar on Drug Benefits
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Peter Johnson Reporter, Health Plan Weekly and Radar on Drug Benefits
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Tim Casey Reporter, Health Plan Weekly and Radar on Drug Benefits
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Carina Belles Reporter, Radar on Medicare Advantage and Spotlight on Market Access
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Jinghong Chen Reporter, Health Plan Weekly and Radar on Drug Benefits
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