CMS Takes Second Shot At Mandating “Trial Size” Prescriptions For Part D; Estimates Savings At $2.5 Billion By 2018
CMS once again has proposed mandating that Medicare Part D prescription drug plan sponsors offer a “trial size” of first-fill prescriptions for medications treating chronic conditions and, in a step further than the previous effort, mandated that the cost-sharing be prorated based on the daily cost of the drug.
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CMS mandates that Part D plans offer prescriptions filled for less than a 30-day period at a daily cost-sharing rate, with a few stated exceptions, but delays implementation until the 2014 plan year.
The Pharmaceutical Research and Manufacturers of America, as well as pharmacy and PBM groups, recommend that CMS test its proposed policy to institute trial-size prescriptions before implementing it on a widespread basis to Medicare Part D.
The Centers for Medicare and Medicaid Services is proposing a new Medicare requirement that consulting pharmacists serving long-term care facilities maintain independence from the facility to help avoid drug “overprescribing and overutilization.”