Part D Protected Class Management Tools To Save Medicare $1.85bn
CMS proposed rule would not eliminate any protected classes but would allow plans to impose additional restrictions on drugs in those classes. Proposal also codifies step therapy for Part B drugs.
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CMS has abandoned its plan to give private plans more leverage in the “protected” drug classes in Part D. It will probably be a long time before anyone tries to change the protected classes again.
Decision in final rule marks a setback in the Trump Administration’s game plan for lowering drug prices. But CMS proceeds with codifying previous guidance allowing step therapy for Part B drugs in Medicare Advantage.
Congressional objections to proposal join opposition by patient and physician groups.