5 recent CMS pharmacy policy changes

In the last month, CMS has announced several policy changes related to drug costs, COVID-19 and more that affect pharmacy operations.

5 recent changes:

  1. CMS caps out-of-pocket insulin costs for Medicare
    CMS is limiting out-of-pocket insulin costs for Medicare beneficiaries to $35 per month.

  2. CMS proposes payment boost for CAR-T therapies
    CMS proposed a payment increase for hospitals administering CAR-T therapy treatments in response to criticism that CAR-T costs aren't sustainable for hospitals.

  3. CMS allows pharmacies to bill Medicare for COVID-19 tests
    CMS implemented a temporary policy that allows pharmacies to bill Medicare for COVID-19 tests, a move that could increase the number of pharmacies able to offer diagnostic testing.

  4. New CMS rule could raise out-of-pocket drug costs
    CMS announced a rule going into effect in July that likely will raise out-of-pocket drug costs for many consumers.

  5. CMS cleared to survey 340B hospitals on their drug acquisition costs
    CMS received final approval to conduct a survey to collect drug acquisition costs for hospitals in the 340B drug-pricing program, a survey hospitals in the program have strongly opposed.

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