CMS Seeks Part D, Advantage Changes to Save $1.3B, Curb Abuses

In an effort to save $1.3 billion over five years and curb the abuse of prescription drugs that Medicare pays for, the CMS is proposing an array of changes to Medicare's Part D and Advantage programs.

In an effort to save $1.3 billion over five years and curb the abuse of prescription drugs that Medicare pays for, the CMS is proposing an array of changes to Medicare's Part D and Advantage programs.

The suggestions range from cutting the number of plans to ensure more meaningful plan choices, ending coverage for drugs for certain illnesses, and changing the way in which pharmacies bid to be included in plans.

The CMS is suggesting that each payer offer no more than two Part D plans in the same service area, saying the limit would give consumers “meaningful differences” in coverage options. The proposed rule would also prohibit Advantage plans from offering coverage options that replace plans the CMS previously required the carrier to terminate or consolidate due to low enrollment.

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Source: Modern Healthcare