Formulary Guidance
This page provides important information on prescription drug coverage policies under Medicare, the framework for CMS' review of Medicare prescription drug plan formularies, and instructions concerning formulary file uploads.
Click the selection that best matches your informational needs. Please check back as we will continue to update these resources regularly.
Please note that Transition related documents have been move to the "Part D Transition" page - click the link in "Links within CMS" to access the page.
Downloads
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Part D Requirements for Biosimilar Follow-On Biological Products (PDF) -
Clarification - Emergency Fill for LTC Residents (PDF) -
Medicare Part B versus Part D Coverage (PDF) -
Transition Guidance (PDF) -
Clarification Formulary Review - "All or Substantially All" (PDF) -
Formulary Review Guidelines (PDF)