Part D, Rebate-Sharing Rules Slated To Be Proposed This Month
Published by Inside Health Policy
Two rules that are expected to include major policies to curb drug prices are scheduled to be released this month, according to the fall regulatory agenda. However, the agenda’s timetable is often wrong. For example, the agenda estimates that the CMS rule requiring the disclosure of drug prices in TV ads would be proposed in December, even though CMS proposed that rule a day before the agenda was published on Tuesday (Oct. 16).
The White House’s budget office is reviewing two rules, a CMS Part D proposed rule and a proposed rule by the HHS Inspector General on anti-kickback safe harbors, that are expected to include policies aimed at lower drug prices, consultants say.
The Part D proposed rule is considered a possible vehicle for changes to plans’ bidding process, the incorporation of pharmacy price concessions into plan bid cost-sharing amounts and the establishment of point-of-sale rebates. According to the title of the anti-kickback proposal, the HHS Inspector General will propose to both remove current safe harbor protections for drug rebates and create new ones. Sources suspect HHS plans to ban, or limit, rebates that are calculated as a percentage of list prices while allowing rebates used in value-based purchasing arrangements.
Click here to see the original article on the Inside Health Policy website.
Recent Posts
-
House Lawmakers Push Bipartisan IRA Fix To Boost LTC Pharmacy Pay
A bipartisan group of House lawmakers introduced legislation aimed at ensuring long-term care (LTC) pharmacies are paid an adequate supply fee to maintain patient access to prescription drugs for which prices are lowered through the Medicare drug price negotiation program, with the new maximum fair prices (MFPs) for the first group of selected drugs to take effect at the start of 2026.
-
Bill would fix drug-negotiation pricing flaw that undercuts LTC pharmacists’ viability
Lawmakers have proposed a supply fee to bolster long-term care pharmacies facing major revenue losses with the implementation of negotiated prices on 10 commonly prescribed medications Jan. 1.
The Preserving Patient Access to Long-Term Pharmacies Act establishes a $30 per Medicare Part D prescription in 2026 and 2027.
-
Rep. Van Duyne Introduces Bipartisan Legislation to Protect Seniors’ Access to Long-Term Care Pharmacies
Washington, D.C. – Representatives Beth Van Duyne (R-TX), Brad Schneider (D-IL), Buddy Carter (R-GA), Sharice Davids (D-KS), and Deborah Ross (D-NC) introduced H.R. 5031 Preserving Patient Access to Long-Term Care Pharmacies Act, bipartisan legislation to protect access to essential medications and pharmacy services for seniors and other long-term care (LTC) residents in nursing homes, assisted living, and similar […]
Stay in the Know
Get the latest news and updates on issues impacting the long-term pharmacy community.