On January 30, 2019, the Centers for Medicare and Medicaid Services (CMS) published an Advanced Notice of Methodological Changes for Calendar Year (CY) 2020 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2020 Draft Call Letter, known as the “ draft Call Letter.” The draft Call Letter outlines payment amounts for beneficiary cost sharing, risk corridors for Part C and Part D plans, and beneficiary payments for calendar year 2020.
HIV positive patients on single tablet regimens have better adherence and lower inpatient health costs, according to a retrospective claims data analysis published in JMCP.
Findings from this review indicate that health care providers approach biosimilars with caution due to limited knowledge, low prescribing comfort, and concerns over safety and efficacy. The authors of this JMCP article recommend clinician-directed education to realize the full cost-saving potential of biosimilars.
On January 30, 2019, CMS issued its draft Part D Payment Policies and 2020 Draft Call Letter.
The draft Call Letter outlines payment amounts for beneficiary cost sharing, risk corridors for Part C and Part D plans, and beneficiary payments for calendar year 2020. Many of the draft provisions for the 2020 plan year revolve around opioids and CMS’s effort to ensure beneficiaries are receiving appropriate pain management therapy. CMS also proposes numerous updates, changes and potential new measure concepts for the Star Ratings Program. CMS is also considering changing policies and is accepting comments relating to its tier composition policy for generics and specialty medications in Part D.
The Academy of Managed Care Pharmacy (AMCP) appreciates the opportunity to provide comments to the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) in response to the draft Strategy on Reducing Burden Relating to the Use of Health IT and EHRs.
On February 28, 2019, AMCP provided comments to the CMS and ONC in response to the draft Strategy on Reducing Burden Relating to the Use of Health IT and EHRs.
On January 25, 2019, AMCP provided comments to CMS in response to its proposed rule on lowering drug prices and reducing out-of-pocket expenses in the Medicare program. The letter outlines the proposal’s impact on providing plan flexibility to manage protected classes, prohibition against gag clauses in pharmacy contracts, E-Prescribing and the Part D Prescription Drug Program, Part D explanation of benefits, and Medicare Advantage and step therapy in Part B.