Quick Summary: Allows Tennessee Medicaid to cover the greater of either one …
Dual Specialty Tiers in Medicare Advantage and Part D Plans: What Does it Mean?
Quick Summary: Allows Medicare Advantage and Part D plans to offer a …
UPDATE: CMS Finalizes Proposed Changes to the Medicaid Drug Rebate Program: What Might That Mean for Value-Based Contracts?
Quick Summary: Finalizes new definition of Value-Based Purchasing (VBP) arrangements Took effect …
CMS Final Rule on the Definition of Line Extension, New Formulation, and Oral Solid Dosage Form for Alternative URA Calculation
Quick Summary: Finalizes a regulatory definition of a “line extension,” “new formulation” …
CMS Final Rule on Impact of Certain Manufacturer Sponsored Patient Assistance Programs on “Best Price” and Average Manufacturer Price (AMP)
Quick Summary: CMS has decided to no longer exclude certain manufacturer-sponsored copay …
HHS Finalizes Payer Transparency Rules
Quick Summary: Beginning in 2022, insurers must post online machine-readable files that …
CMS Finalizes Rule Permitting Copay Accumulator Adjustment Programs in 2021: What Does It Mean?
Quick Summary: CMS finalizes rule allowing plan sponsors to utilize a Copay …
Proposed Changes to the Medicaid Drug Rebate Program: What Might That Mean for Value-Based Contracts?
Quick Summary: CMS proposes two potential rules for adjusting “best price” determinations …
CMS Launches Model to Lower Out-of-Pocket Expenses for Insulin
Quick Summary: Lowers Medicare beneficiaries’ out-of-pocket costs for a broad set of …