The US Centers for Medicare and Medicaid Services is proposing to allow Medicare Part D plans to exclude drugs with substantial price increases from coverage, even if they are in one of six protected classes, in order to generate savings to the government and for beneficiaries.
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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