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.

© 2021 MMIT

Peter Johnson

Peter has been a reporter for nearly a decade. Before joining AIS Health, Peter covered a wide variety of topics in his hometown of Seattle, where he continues to live. Peter’s work has appeared in publications including The Atlantic and The Stranger. Peter attended Colby College.

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