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.

AMCP Summary of Medicare Part B Most Favored Nation Model

On November 20, HHS released an Interim Final Rule with Comment Period (IFC) establishing a Most Favored Nation (MFN) Model for Medicare Part B drugs. The MFN Model will calculate the payment rate for included drugs based on a price that reflects the lowest per capita GDP-adjusted price among a group of OECD countries, with an additional flat payment based on the average payment for MFN Model drugs in 2019 adjusted quarterly for inflation.

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

AMCP Submits Comments on Medicare Coverage of Innovative Technology Proposed Rule

On November 2, AMCP submitted comments on a CMS Medicare Coverage of Innovative Technology proposed rule establishing a national coverage pathway for innovative devices authorized under FDA’s Breakthrough Devices Program and clarifying the agency’s definition of “reasonable and necessary”. AMCP called on CMS to indicate how digital therapeutics (DTx) will fit into Medicare’s coverage and payment framework in its Final Rule.

AMCP Submits Comments on CMS Third COVID Interim Final Rule

On November 2, AMCP submitted comments on CMS’s Third Interim Final Rule responding to the COVID-19 emergency, thanking the agency for granting pharmacists the authority to order COVID-19 diagnostic tests for Medicare beneficiaries and expressing concern about the agency’s new guidance which would limit COVID-19 diagnostic tests without an order.

AMCP Submits Comments to CMS About the Part D MTM Program

On Oct. 5, AMCP submitted comments about the Part D MTM program, specifically in regards to the ability of plan sponsors and MTM vendors to provide annual CMR to individuals other than the beneficiary in certain circumstances in which the beneficiary is unable to participate.

AMCP Comments on the COVID-19 Vaccine Distribution Preliminary Framework

AMCP submitted comments to the National Academies of Science, Engineering, and Medicine’s draft Preliminary Framework for COVID-19 Vaccine detailing our support to recognize pharmacists as front-line health care workers and pharmacies be included in the vaccine distribution and allocation plans.

AMCP Letter to HHS Secretary Azar on Anti-Kickback Statute Concerns

AMCP sent a letter to HHS Secretary Azar detailing our concerns with the recent Executive Order that would make changes to the anti-kickback statute safe harbor for manufacturer rebates and the potential for increased costs for patients.