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Delay of Inclusion of Territories in Medicaid Drug Rebate Program; Covered Outpatient Drug Interim Final Rule (CMS 2345-IFC3)

On February 1, 2016, the Centers for Medicare & Medicaid Services (CMS) published the “Medicaid Program; Covered Outpatient Drug” Final Rule with Comment Period (CMS-2345-FC) in the Federal Register (81 FR 5170). 
Nov 21, 2019 Newsroom Fact Sheet

Claim Rejection and Denials for Providers on the Preclusion List to begin on April 1, 2019

Apr 01, 2019 Newsroom Fact Sheet

Contract Year (CY) 2020 Medicare Advantage and Part D Drug Pricing Proposed Rule (CMS-4180-P)

CMS is committed to implementing President Trump’s blueprint to lower drug costs and reduce out-of-pocket costs for patients. In line with the policies discussed in the President’s blueprint, CMS issued a proposed rule on November 26, 2018 that solicits public comments on potential policies that would remove administrative hurdles to offer lower cost options to seniors and provide support for private sector partners by providing them the tools to lower the cost of prescription drugs.
Nov 26, 2018 Newsroom Fact Sheet

ANPRM International Pricing Index Model for Medicare Part B Drugs

The Centers for Medicare & Medicaid Services (CMS) is committed to implementing President Trump’s blueprint to lower drug costs and reduce out-of-pocket costs for patients. In line with the policies discussed in the President’s blueprint, the CMS is soliciting public comments on potential options we may consider for testing changes to payment for certain separately payable Part B drugs and biologicals (“drugs”).
Oct 25, 2018 Newsroom Fact Sheet

Indication-Based Formulary Design Beginning in Contract Year (CY) 2020

Today, the Centers for Medicare & Medicaid Services (CMS) announced additional flexibilities in the Medicare Part D program to allow for innovative formulary design as a valuable approach to expand drug choices and address the challenge of high drug costs for seniors and government programs.
Aug 29, 2018 Newsroom Fact Sheet

Medicare Advantage Prior Authorization and Step Therapy for Part B Drugs

Today, the Centers for Medicare & Medicaid Services (CMS) introduced much-needed competition and negotiation into the market for physician-administered and other Part B medications that will result in better deals and lower drug costs for patients. As part of the agency’s ongoing activities to deliver on President Trump’s promises outlined in his American Patients First Blueprint, CMS will provide Medicare Advantage plans the option of applying step therapy for physician-administered and other Part B drugs in a way that lowers costs and improves the quality of care for Medicare beneficiaries.
Aug 07, 2018 Newsroom Fact Sheet

CMS proposes Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System changes for 2019 (CMS-1695-P)

On July 25, 2018, CMS proposed changes that would encourage site-neutral payment between sites of services and make healthcare prices more transparent for patients so that they can be more informed about out-of-pocket costs.
Jul 25, 2018 Newsroom Fact Sheet

Speech: Remarks by CMS Administrator Seema Verma at the Pharmacy Quality Alliance Annual Meeting

Good afternoon, it’s a pleasure to be with you today. Pharmacists are on the front lines of patient care and have keen insight to the issues that patients face. We appreciate your hard work, and we look forward to working with you on a goal that I’m sure we share – ensuring that all patients can access their medications at an affordable price.
May 16, 2018 Newsroom Fact Sheet

Drug Spending Information Products Fact Sheet

Today, the Centers for Medicare & Medicaid Services announced the release of updated information products that provide greater transparency on drug spending in the Medicare and Medicaid programs.
May 15, 2018 Newsroom Fact Sheet

Speech: Remarks by CMS Administrator Seema Verma at the American Hospital Association Annual Membership Meeting

Good morning, and thank you for that kind introduction. I also want to thank the American Hospital Association for the invitation. For those of you that don’t know me, I spent the early days of my career at a public hospital.
May 07, 2018 Newsroom Fact Sheet

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