CMS is hosting a November 14, 2016 "listening session" to obtain stakeholder input on implementation of section 704 of the Comprehensive Addiction and Recovery Act of 2016 (CARA), Under this provision, Medicare Part D sponsors may establish drug management programs for at-risk beneficiaries to limit access to frequently-abused drugs to certain prescribers and pharmacies. Topics for the call include, among others: clinical guidelines that indicate misuse or abuse of frequently abused drugs; the anticipated impact of drug management programs for at-risk beneficiaries on cost-sharing and accessibility to prescription drugs; the use of an expedited appeals regarding an enrollee's identification as an at-risk beneficiary; drug plan sponsor implementation responsibilities; notification requirements; evidence-based prescribing guidelines for opiates; and the sharing of Part A and B claims data with Part D sponsors. CMS invites participation by Medicare beneficiaries and advocacy groups, pharmacies, plan sponsors, pharmacy benefit managers, and other interested parties.
This article is presented for informational purposes only and is not intended to constitute legal advice.
