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Medicare Negotiated Prices: CMS Seeking Private Sector Input On Implementation At Point Of Sale

 
• By Cathy Kelly

Agency issues a request for information on establishing a “Medicare Transaction Facilitator” function at the pharmacy counter. CMS wants point of sale processes to ensure negotiated prices go only to eligible beneficiaries and that there is no duplication with 340B discounts, two concerns for manufacturers.

Responses are Requested By 13 November. • Source: Shutterstock

The Centers for Medicare and Medicaid Services wants to tap private sector expertise to help implement Medicare-negotiated “maximum fair prices” at the pharmacy counter beginning in 2026 for the 10 Part D drugs selected for the first round of negotiation, according to a request for information issued by the agency on 18 October.

Key Takeaways

  • The request for information explores how a private sector entity could handle the logistics of applying negotiated prices at the pharmacy counter.

The RFI is intended to “research the availability and potential technical ability of healthcare-related organizations to provide … data exchange,...

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