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CMS: Part D Plans Will Allow Indication-Based Formularies in 2020

August 31, 2018

In the latest CMS move aimed at reducing drug prices, Administrator Seema Verma released new guidance on how Part D plan sponsors can negotiate formulary coverage based on specific indications starting in 2020.

The new formulary tool will give Part D plans additional leverage when negotiating with manufacturers, in turn reducing beneficiary and program costs, Verma said.

“We are announcing this policy change at this time in order to provide ample notice to plans prior to their negotiations with manufacturers on CY 2020 formulary inclusion,” she said.

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