CMS may bring on contractor to examine Medicare Part D plans: 3 things to know

CMS is seeking a contractor to assess whether Medicare Part D plans are administering drug lists and benefits lawfully.

Advertisement

Here are three things to know about the request.

1. CMS is looking for a contractor to conduct yearly analyses and summaries on Medicare Part D plans’ formularies and compliance.

2. The move comes as several Medicare Part D plans — which cover more than 42 million beneficiaries — faced scrutiny in the past year over noncompliance. In March, CMS fined UnitedHealthcare $2.5 million after an audit found systemic compliance problems with its Part D plans that caused beneficiaries to experience delayed or denied access to prescription drug coverage.

3. Submitted responses to CMS’ request are due Dec. 21.

More articles on payer issues:
BCBS of Massachusetts to pay members up to $250 per procedure when they shop
Virginia officials say state’s CHIP program may end Jan. 31
UnitedHealth urges judge to drop lawsuit claiming the payer defrauded Medicare $1B+

Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit

Advertisement

Next Up in Legal & Regulatory Issues

Advertisement

Comments are closed.