CMS Backs Off Negotiated Price Rules for Part D, Medicare Advantage Drugs

May 23, 2019

The Centers for Medicare and Medicaid Services has backed off a proposed rule that would have used the lowest possible payment to a pharmacy as the baseline price for Medicare.

A final rule published Thursday also scrapped language that would give CMS the authority to negotiate discounts in Medicare Part D’s “protected” therapeutic classes. The proposal generated more than 4,000 comments on the proposed rule’s docket, regulators said.

“However, the administration remains concerned that prescription drug companies are offering seniors in Medicare substantially smaller discounts for protected class drugs than are offered in the commercial market,” the agency said.

It’s a break from the rule originally proposed last November.

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