CMS lowers the cost of prescription drugs for Medicare beneficiaries

CMS on Monday finalized polices for Medicare health and drug plans for 2019. The agency is finalizing a reduction in the maximum amount that low-income beneficiaries pay for biosimilars.

CMS on Monday finalized polices for Medicare health and drug plans for 2019. The agency is finalizing a reduction in the maximum amount that low-income beneficiaries pay for biosimilars. Other actions include allowing for certain low-cost generic drugs to be substituted onto plan formularies at any point during the year, so beneficiaries immediately benefit and have lower cost sharing; increasing competition among plans by removing the requirement that certain Part D plans have to "meaningfully differ" from each other; and increasing competition among pharmacies by clarifying the "any willing provider" requirement, to increase the number of pharmacy options that beneficiaries have. CMS also reports it is providing Medicare with additional tools to combat opioid overprescribing and abuse. For example, CMS is finalizing a new authority that permits Part D sponsors to require beneficiaries at risk of addiction or overuse to use only selected prescribers or pharmacies for opioid prescriptions.