7 things to know on CM Medicare Prescription Drug Proposed Rule: Becker's

1. The proposed rule, which focuses on "protected classes" of drugs, provides Medicare Advantage and Part D plans more tools to negotiate lower drug prices.
2. Current policy requires Medicare Part D plans to cover drugs in the following six categories: antidepressants, antipsychotics, anticonvulsants, immunosuppressants,antiretrovirals, and antineoplastics
3. The proposed rule would allow Part D plans to implement broader use of step therapy and prior authorization, even within protected classes.
4. Medicare Part D plans would be required to provide enrollees and their physicians with a patient's out-of-pocket cost obligations for prescription drugs when a prescription is written
5. The proposed rule implements a statutory requirement that prohibits pharmacy gag clauses in Part D
6. The proposed rule codifies a policy to allow "step therapy" in Medicare Advantage for Part B drugs.
7. CMS said it is considering a policy that would require pharmacy rebates to be passed on to seniors.

Source: Becker's Hospital Review
Source URL: https://www.beckershospitalreview.com/pharmacy/cms-proposes-...

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