Legislation & Regulation

Discover essential legislative and regulatory resources tailored for managed care pharmacy professionals. Stay informed with the latest updates, policies, and advocacy tools to effectively navigate and influence the health care landscape.

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AMCP Comment on Draft CY 2025 Part D Redesign Program Instructions

On January 31, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Draft Guidance titled “Draft Part D Redesign Program Instructions (Program Instructions)”, concurrently with the Advance Notice. The Draft Part D Redesign Program Instructions provide draft guidance regarding the implementation of certain Inflation Reduction Act (IRA) provisions relating to the Part D drug benefit. CMS is soliciting comments on all aspects of the Guidance, and notes that policies established in the final Guidance are for 2025. AMCP submitted comments in response to this rule on March 1, 2024.
Legislation & Regulation
COVID Medical Professionals - Stock

White, Brown, Clear, and Gold Bagging

AMCP recognizes that many patients today depend on high‐cost specialty medications that often do not have therapeutic alternatives. Medication cost-share offset programs provide out-of-pocket discounts or free product at the point of sale.
Legislation & Regulation
Addressing-Evidence-Gaps-in-Accelerated Approval Programs Payer Perspectives - Cover

Addressing Evidence Gaps in the FDA Accelerated Approval: Payer Perspectives

AMCP convened key stakeholders in managed care to address the balance between patient access and payer requirements in the FDA Accelerated Approval (AA) pathway program. Experts from various fields participated, aiming to identify gaps between FDAAA requirements and payer-valued treatment outcomes, explore evidence ecosystem opportunities, and evaluate policy options. The forum emphasized supporting drug development innovation while recognizing payer needs and promoting stakeholder trust in the AA review process. Notably, incentivizing confirmatory trials emerged as a potential impactful policy solution.
Legislation & Regulation, Managed Care Practice Issues, Expedited Approval

AMCP Joins Patient and Provider Groups in Urging the Supreme Court to Preserve FDA Authority

On January 30, AMCP joined 24 patient and provider organizations in filing an amicus brief which urges the Supreme Court to reverse the Fifth Circuit's decision in "Alliance for Hippocratic Medicine et al. v FDA et al". The filing organizations believe that the ruling threatens the FDA's role in ensuring Americans' access to safe, effective drugs and treatments.
Legislation & Regulation

AMCP Responds to Senate RFI Regarding Cell and Gene Therapies

On December 5, Senate Health, Education, Labor, & Pensions (HELP) Committee Ranking Member Bill Cassidy (R-LA) released a Request for Information (RFI) titled "Improving Access to Americans' Gene Therapies." On January 22, AMCP submitted a letter in response, which positions the Medicaid VBPs for Patients (MVP) Act of 2023 (H.R. 2666) as a useful tool for improving access to and the affordability of emerging cell and gene therapies. The MVP Act of 2023 codifies the existing “multiple best price” rule that allows manufacturers to report multiple best prices, the lowest drug price paid by any health payer, for drugs that are subject to value-based purchasing arrangements when certain other criteria are met.
Legislation & Regulation

January 2024 Legislative & Regulatory Briefing

January 2024 Legislative & Regulatory Briefing: AMCP Unveils New Pharmacy Advocacy Leaders (PAL) Program; AMCP Comments on Regulatory Considerations for Prescription Drug Use-Related Software; AMCP Comments on Medicare Program; Contract Year 2025 Policy and Technical Changes to the Medicare Advantage Program; AMCP Comments on HHS Notice of Benefit and Payment Parameters for 2025; AMCP Report Illustrates Benefits of Managed Care Pharmacy.
Legislation & Regulation
AMCP Caragon

January 2024 Legislative & Regulatory Briefing

January 2024 Legislative & Regulatory Briefing: AMCP Unveils New Pharmacy Advocacy Leaders (PAL) Program; AMCP Comments on Regulatory Considerations for Prescription Drug Use-Related Software; AMCP Comments on Medicare Program; Contract Year 2025 Policy and Technical Changes to the Medicare Advantage Program; AMCP Comments on HHS Notice of Benefit and Payment Parameters for 2025; AMCP Report Illustrates Benefits of Managed Care Pharmacy.
Legislation & Regulation

Pharmacy Organizations Raise Concerns About Florida's Drug Importation Program

On January 17, AMCP joined dozens of other pharmacy organizations in a joint letter which expresses concerns about the FDA's recent authorization of Florida's state drug importation program. The undersigning organizations believe this importation program may lead to the importation of harmful and counterfeit drugs into the United States, with little evidence of cost savings. The organizations remain committed to alleviating the high cost of medicines in the United States, but oppose state drug importation programs that may compromise patient safety.
Legislation & Regulation

AMCP, Healthcare Organizations Urge CMS to Maintain Stability in the Medicare Advantage Program

On Jan. 11, AMCP joined with 65 other healthcare organizations in a sign-on letter urging the Biden Administration to implement policies that would stabilize and support a strong, sustainable Medicare Advantage program for its beneficiaries. The letter comes as the Administration and CMS continue to enact significant policy changes to the Medicare Advantage program, which serves 51 percent of the Medicare population.
Legislation & Regulation