Archives     Advertise     Editorial Calendar     Subscribe     Contact Us    


CMS proposes policies to lower the cost of prescription drugs and combat the opioid crisis


 

Today, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that includes a number of changes that, if finalized, will ensure that Part D Medicare enrollees have access to more affordable prescription drugs and more robust prescription drug coverage at the pharmacy they prefer. The rule also gives health plans a new tool to combat the opioid crisis.

The President has been committed to lowering drug prices for seniors and fighting the opioid epidemic. In response, CMS is working to lower drug prices by removing administrative hurdles to offer lower cost options to seniors on Medicare, as well as supporting private sector partners by providing them a much needed tool in the fight to end the opioid epidemic.

CMS is proposing to lower drug costs by providing flexibility for certain mid-year changes to prescription drug formularies when a new generic drug becomes available and is clinically appropriate, while protecting beneficiaries who require the brand name drug. This change will provide flexibility to switch to lower cost prescription drugs and pass those savings on to Medicare beneficiaries.

CMS is also proposing to lower drug costs by treating lower-cost "biosimilar" versions of biologic products like other generic drugs when determining how much certain beneficiaries pay for drugs out of pocket under Medicare Part D. This change will encourage the availability of lower-cost alternatives for Medicare beneficiaries.

The proposed rule also includes a Request for Information on applying discounts drug companies provide to health plans to the price beneficiaries pay at the pharmacy counter. CMS is requesting input on whether this idea would maximize cost-sharing savings for beneficiaries, how they might best be implemented and what the implications would be for various stakeholders and taxpayers.

CMS is also empowering beneficiaries to access their prescription drugs at the pharmacy they prefer. CMS is proposing to revise the pharmacy participation rules in Part D which will promote greater participation of local pharmacies in Part D and preserve beneficiary access to all types of pharmacy delivery services, including mail-order.

To help address the national health crisis created by opioid abuse, CMS is proposing to implement new authority that allows Part D plans to require certain beneficiaries to obtain their prescriptions for opioids from selected prescribers or pharmacies. The proposal would provide an important new tool to combat the growing opioid epidemic that is devastating families and communities across the nation.

For a fact sheet on the proposed rule, please visit: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-11-16.html.

The proposed rule (CMS-4182-P) can be downloaded from the Federal Register at: https://www.federalregister.gov/public-inspection.

 
Share:

Related Articles:


Recent Articles

Integrating AI in Healthcare

Technology has advanced to a point where AI in healthcare is increasingly common. Now the challenge is utilizing data in a way that is not only predictive but also prescriptive to improve health and outcomes.

Read More

AMA Advances New Principles to Put AI into Practice

AHIP isn't the only national organization focused on how AI might be effectively deployed to improve patient engagement, care and interaction with the broader healthcare system.

Read More

State of Technology

Nashville HIT leaders address challenges, accomplishments of the region's thriving healthcare IT market.

Read More

Helping Children and Athletes Breathe Easier

Experiencing shortness of breath during exercise can be extremely distressing, particularly when it occurs in a child, teen or young adult.

Read More

PHYSICIAN SPOTLIGHT: Between Medicine and Technology

When it comes to rolling out new systems, Neal Patel, MD, said listening to users and understanding concerns are critical to success.

Read More

Navigating the Risks of New Healthcare Technologies

New technologies in healthcare hold great promise, but with that promise come risks that must be considered and addressed.

Read More

Tech Talk

Recent news of note in Middle Tennessee's health tech sector.

Read More

Enhancing Access to Care through Technology

Innovative technology allows patients, health plans to schedule appointments online.

Read More

Reimaging Residency

A joint project between Vanderbilt and Ole Miss was one of eight selected by the American Medical Association to reimagine residency programming.

Read More

Tips & Traps: Expert Insights from NMGMA Leadership

NMGMA's president and president-elect share insights borne of experience to help practice managers enhance success.

Read More

Email Print
 
 

 

 


Tags:
None
Powered by Bondware
News Publishing Software

The browser you are using is outdated!

You may not be getting all you can out of your browsing experience
and may be open to security risks!

Consider upgrading to the latest version of your browser or choose on below: