CMS Issued Update to the Frequently Asked Questions related to the Medicare Prescription Payment Plan
On Nov. 15, 2024, the Centers for Medicare & Medicaid Services (CMS) issued an update to the set of frequently asked questions (FAQs) related to the Medicare Prescription Payment Plan originally issued on Oct. 1, 2024. The updated FAQs included the following change:
- The Medicare Prescription Payment Plan covers only medications included in the Medicare Prescription Drug Benefit (Part D). Drugs from manufacturer Patient Assistance Programs (PAPs) are not eligible for this plan. However, if a Part D enrollee is in the Medicare Prescription Payment Plan and has other prescriptions for covered Part D medications (not part of a PAP), those prescriptions will be fully covered.
Please refer to our previous NewsBREAK for more information.
- FAQ Sheet
- Updated FAQ Sheet
- AMCP 10/1/24 NewsBREAK
- Final Part One Guidelines
- Final Part Two Guidelines
- Medicare Prescription Drug Benefit Manual, Chapter 14
For questions, please reach out to Vicky Jucelin.
Related
On December 20, 2024, the Centers for Medicare & Medicaid Services (CMS) issued explanations for the maximum fair prices (MFPs) for the drugs selected for the IRA’s Medicare Drug Price Negotiation Program for the initial price applicability year (IPAY) 2026.
On Dec. 12, 2024, the Centers for Medicare and Medicaid Services (CMS) issued a final rule titled, “Modifications of Health Insurance Portability and Accountability Act of 1996 (HIPAA) National Council for Prescription Drug Programs (NCPDP) Retail Pharmacy Standards; and Modification of the Medicaid Pharmacy Subrogation Standard” (Final Rule).
On December 4, 2024, the Centers for Medicare and Medicaid Services (CMS) announced that two drug manufacturers of gene therapies for sickle cell disease have entered into agreements to participate in the Cell and Gene Therapy Access Model (CGT Access Model).
Featured News & Resources
See Full Calendar
Other Events
HBCU Travel Awards for AMCP25
Other Events
Mid-South AMCP Day of Education 2025
Other Events
Southwest AMCP Annual Day of Education 2025
Upcoming Events
AMCP offers a wide variety of educational opportunities, from events and webinars to online training.
