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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.
Fact sheet

CMS Takes Action to Lower Prescription Drug Costs by Modernizing Medicare

Today, the Centers for Medicare & Medicaid Services (CMS) proposed polices for 2020 to strengthen and modernize the Medicare Part C and D programs. The proposal would ensure that Medicare Advantage and Part D plans have more tools to negotiate lower drug prices, and the agency is also considering a policy that would require pharmacy rebates to be passed on to seniors to lower their drug costs at the pharmacy counter.
Press release

Remarks by Administrator Seema Verma at the Biopharma Congress

Administrator Seema Verma's remarks regarding CMS’ drug pricing efforts given at the Biopharma Congress (As prepared for delivery – November 14, 2018)
Press release

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”).
Fact sheet

CMS Proposes to Require Manufacturers to Disclose Drug Prices in Television Ads

Proposed rule would further the Trump Administration’s commitment to lower prescription drug prices by requiring companies to list prices for prescription drugs covered in Medicare or Medicaid.
Press release

Speech: Remarks by Administrator Seema Verma at the Financial Times Pharma Pricing and Value Summit

Remarks by Administrator Seema Verma at the Financial Times Pharma Pricing and Value Summit (As prepared for delivery – September 13, 2018)
Press release

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.
Fact sheet

CMS provides new flexibility to increase prescription drug choices and strengthen negotiation for Medicare enrollees

The Centers for Medicare & Medicaid Services (CMS) issued a memo today to Medicare Part D plans, which cover prescription drugs that beneficiaries pick up at a pharmacy, offering plans new tools and flexibility to expand choices and lower drug prices for patients.
Press release

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.
Fact sheet