Tavenner Withdraws Fractious Part D Changes

Under pressure from the industry and Congress, the Centers for Medicare & Medicaid Services is withdrawing several proposed changes to the Medicare drug program, but still charging ahead with others that could prove disruptive.

Under pressure from the industry and Congress, the Centers for Medicare & Medicaid Services is withdrawing several proposed changes to the Medicare drug program, but still charging ahead with others that could prove disruptive.

In a large batch of Medicare Part D proposed regulations first published in January, CMS announced plans to end three protected classes of drugs, standardize preferred pharmacy networks, extend negotiated drug pricing across the program and limit the number of plans available in a region, among other things the agency argued would collectively help save $1 billion over five years.

Those proposals and others drew criticism from various corners of Congress and the health, insurance and pharmaceutical industries, especially the elimination of the protected classes of antidepressants, antipsychotics and immunosuppressants and a new interpretation of the Part D “non-interference” clause that would give every pharmacy the ability to contract with plans under preferred terms and conditions.

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Source: Healthcare Payer News