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 April 16, 2025, the Centers for Medicare and Medicaid Services (CMS) issued guidance on CY 2026 Part D Formulary Submissions (Guidance). The Guidance includes important dates related to CY 2026 formulary submissions.
On April 15, 2025, the Trump administration issued an Executive Order (EO) on prescription drug costs.
On April 7, 2025, the Centers for Medicare and Medicaid Services issued the Calendar Year (CY) 2026 Rate Announcement and Final CY 2026 Part D Redesign Program Instructions.
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