Keeping Up with Legislative and Regulatory Matters
ACPE UAN: 0233-0000-19-026-L04-P | Contact Hours: 1.25 | Activity Type: Knowledge-based
The Centers for Medicare and Medicaid (CMS) continues to critically evaluate formulary regulations and guidance to help lower drug costs. This session will inform health plans, pharmacy benefit managers (PBMs) and other health care professionals about the CMS changes to Medicare Part D that will be implemented in 2019 and 2020, and their operational and financial implications. Changes that will be covered include allowing health plans and PBMs to utilize step therapy for Part B drugs while integrating with care coordination programs; the allowance of indication-based formularies; and substituting generics for brands as soon as they are available without CMS prior approval. Faculty will also review other new changes from the CMS 2020 Call Letter that will impact the health care community.
At the completion of this activity, participants should be able to: