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As the Centers for Medicare & Medicaid Services (CMS) closes in on finalizing anticipated 2019 changes to Medicare and several other CMS-sponsored programs, the NAM urges CMS to refrain from changing its “Any Willing Pharmacy” requirements. Employers and employees increasingly rely on Medicare, Medicare Advantage (MA) and Part D drug benefit programs for health coverage as some employers are sponsors of Part C and D plans for their retirees.

Competitive principles are a hallmark of the Part D program and have kept the program affordable for seniors over the last decade. This proposal directly conflicts with the Part D spirit and intent by adding new challenges and barriers to the establishment of preferred pharmacy networks. As stated in a public comment submitted earlier this year, we highlighted that preferred pharmacy networks allow for more streamlined management of pharmacy benefits by working to reduce fraud, waste, and abuse, lowering the cost of the benefit for all Medicare beneficiaries and promoting the delivery of high quality pharmacy services.

Most beneficiaries today choose to enroll in Part D plans with preferred pharmacies and this proposal would disrupt their coverage without producing a benefit. Manufacturers strongly support proposals to reduce soaring health care costs, improve the efficiency of the current system and enhance the quality of care. However, the proposed changes by CMS don’t meet those tests. A recent Oliver Wyman report confirms the value of preferred pharmacy networks in the Part D program and employers agree.

The post Manufacturers Urge Maintaining the Value of Present Part D Networks appeared first on Shopfloor.


As the Centers for Medicare & Medicaid Services (CMS) closes in on finalizing anticipated 2019 changes to Medicare and several other CMS-sponsored programs, the NAM urges CMS to refrain from...

The post Manufacturers Urge Maintaining the Value of Present Part D Networks appeared first on Shopfloor.


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