The Centers for Medicare & Medicaid Services Aug. 29 announced that beginning in 2020 it will allow Medicare Part D plans to vary the formulary placement of a drug based on what condition the drug may treat. Today, if a health plan covers a drug, it must cover it for all approved indications unless a particular use is not covered under Part D generally. According to CMS, this flexibility will give plans greater negotiating leverage with drug manufacturers and reduce the prices they pay for drugs. For more information, see the CMS factsheet.

Headline
The AHA provided comments to the Medicare Payment Advisory Commission Oct. 2 on a discussion from the commission’s September meeting on its examination of…
Headline
The Centers for Medicare & Medicaid Services Sept. 30 finalized its Global Benchmark for Efficient Drug Pricing Model, also known as the GLOBE Model. The…
Headline
The Centers for Medicare & Medicaid Services announced Sept. 25 that it will expand the Inpatient Rehabilitation Facility Review Choice Demonstration to…
Headline
The Centers for Medicare & Medicaid Services announced Sept. 28 that it projects declines in average premiums for Medicare Advantage and Part D in 2027.…
Headline
The Centers for Medicare & Medicaid Services announced Sept. 18 that all 50 states, Washington, D.C., and Puerto Rico have applied to participate in its…
Headline
The Centers for Medicare & Medicaid Services Sept. 15 announced an expansion of its outcome-aligned payment model offering technology-supported care to…