Letters, Statements & Analysis

AMCP communicates the importance of managed care pharmacy by collaborating with members to provide comments, analysis, and testimony to Congress and federal and state agencies on the impact of proposed regulations and laws on managed care pharmacy and patients.

Supply Chain Stakeholder Recommendations to CMS on COVID Vaccine Reimbursement

On April 19, AMCP submitted joint recommendations to CMS on Medicare Advantage enrollees seeking COVID-19 vaccine without their Original Medicare card. CMS is recommended to present clear guidance to all vaccination sites and providers and instruct MACs to provide assistance to providers to ensure vaccine administration is accurately reimbursed and entered into the COVAX portal.
COVID-19

AMCP Signs Medicaid Stakeholder Letter to Congressional Leaders

On Feb. 18, AMCP joined the Modern Medicaid Alliance in urging Congress to strengthen the Medicaid program in the next COVID response bill by increasing the Federal Medical Assistance Percentage (FMAP) by at least 12 percentage points.

AMCP Submits Comments on Most Favored Nation Model Rule

AMCP submitted comments to CMS on the Most Favored Nation Model rule, expressing our significant concerns that the model would negatively impact patient access to needed medications.

AMCP Joins Pharmacy IT Coalition to Comment on CMS Prior Authorization Proposed Rule

On Jan. 5, AMCP joined the Pharmacy Health Information Technology (PHIT) Collaborative and national pharmacy stakeholders in submitting comments to CMS on its Medicaid prior authorization proposed rule. AMCP supports expanding use of electronic prior authorizations, removing barriers to health information technology adoption and providing patients and providers with information regarding prior authorization decisions.
Health Technology

AMCP Summary of MDRP Rule

On Dec. 21, CMS published a Final Rule to support state flexibility to enter into value-based purchasing arrangements (VBPs) with drug manufacturers, and to allow manufacturers with qualifying VBPs to report multiple best price points for a single dosage form and strength of a covered outpatient drug. The final rule is effective on Jan. 1, 2022.

AMCP Submits Comments on CMS Draft Guidance for CY 2022 Medicare Advantage Capitation Rates, Part C and Part D Payment Policies — Part II

On Nov. 30, AMCP submitted comments on CMS draft guidance for Calendar Year (CY) 2022 Medicare Advantage capitation rate and Part C and Part D payment policies. AMCP responded to CMS’s proposed introduction of a COVID-19 measure for the 2023 Part C and Part D performance measure display page and in the Star Ratings program, pending rulemaking.

AMCP Summary of Medicare Part D Rebate Rule

On November 20, HHS released a Final Rule that amends the discount safe harbor regulation to eliminate protections for price concessions offered by pharmaceutical manufacturers to plan sponsors and pharmacy benefit managers (PBMs) under contract with plan sponsors starting January 1, 2022.
Medicare Part D