tci Medicare Compliance & Reimbursement - 2005 Issue 27

MEDICARE DRUG BENEFIT: CMS Demanding Extensive Formularies From PDPs

Some sponsors say government going back on its word.Could the Part D drug benefit wind up being a lot less profitable than many prospective sponsors hope?New guidance released by the Centers for Medicare and Medicaid Services echoes what the agency has been telling many sponsors in one-on-one meetings about the sponsors' formulary designs, and the news is troubling to some health plans and pharmacy benefit managers. In a new Frequently Asked Questions document available on its Web site, CMS reiterates that sponsors of prescription drug plans will need to include in their formularies "all or substantially all"...

To read the full article, sign in and subscribe to tci Medicare Compliance & Reimbursement.

Thank you for choosing Find-A-Code, please Sign In to remove ads.