Legislation & Regulation

Draft report from AHRQ.

On February 20, 2015, CMS released its 2016 Part D Call Letter in a notice to Medicare Advantage organizations and Prescription Drug Plan sponsors.

On August 22, 2014, the DEA issued a final rule (79 FR 49661) in which they rescheduled hydrocodone combination products (HCPs) from schedule III to schedule II of the Controlled Substances Act as of October 6, 2014.

The Centers for Medicare and Medicaid Services (CMS) recently released an updated guidance and standard prior authorization (PA) form for medication coverage for hospice beneficiaries. It supersedes a guidance released on March 10, 2014 (but implemented on May 1, 2014).

Clarifications to the 2014 Policy on Automatic Delivery of Prescriptions

The Centers for Medicare and Medicaid Services (CMS), will allow for certain MTM activities and fraud reduction activities to count toward Medicare Part D and Medicare Advantage medical loss ratio (MLR)

On May 23, 2013, CMS finalized a rule that will allow for certain MTM activities and fraud reduction activities to count toward Medicare Part D and Medicare Advantage medical loss ratio (MLR).

This final rule implements new medical loss ratio (MLR) requirements for the Medicare Advantage Program and the Medicare Prescription Drug Benefit Program established under the Patient Protection and Affordable Care Act

On October 22, 2009 CMS proposed revisions to the Medicare Advantage (MA) program (Part C) and prescription drug benefit program (Part D).

Medication Therapy Management in Pharmacy Practice: Core Elements of an MTM Service Model Version 2.0 is an evolutionary document that focuses on the provision of MTM services in settings where patients or their caregivers can be actively involved in managing their medications. The original version 1.0 document described the foundational or core elements of MTM services that could be provided by pharmacists across the spectrum of community pharmacy.