BioCentury
ARTICLE | Politics & Policy

CMS draft call letter silent on protected classes

February 22, 2014 1:46 AM UTC

A draft of CMS's annual call letter informing insurers of plan requirements for 2015 does not address a proposed change to Medicare Part D that would eliminate antidepressants and immunosuppressants from the list of protected classes for which plans must provide "substantially all" approved drugs. The proposed rule change, which was issued in January, would take effect in calendar year 2015.

The draft call letter does address a section of the proposed rule that requires preferred pharmacy networks be expanded in 2015 to include all pharmacies willing to match the discounts offered by the preferred pharmacies with which a plan contracts. In the letter, CMS said it will review networks offering preferred cost sharing and will take "appropriate action" regarding any network appearing to offer "too little meaningful access." ...