August 15, 2018

Drug Pricing Policy: HHS Introduces Step Therapy In Medicare Advantage

From: Health Affairs Blog

Rachel Sachs


Finally, CMS’ boldest action to date might come in a proposed rule currently under review at the Office of Information and Regulatory Affairs. The rule proposes to eliminate the current safe harbor protection for pharmaceutical rebates under the anti-kickback statute and to create a new safe harbor. Without more information, it is not known how important this proposal will be, and many procedural steps (and therefore many months) remain before such a rule could be finalized. (Incidentally, MA plans often rely on pharmacy benefit managers (PBMs) to help control their Part B spending, so although the administration may seek to limit the power of PBMs with this proposed rule, the step therapy announcement doubles down on their importance.)

Read Complete Article

No Comments »

No comments yet.

Leave a Reply

Name not required for anonymous comments. Email is optional and will not be published.