Last week, CMS released the Part D proposed rule, as well as Part II of the advance notice of changes for Medicare Advantage capitation rates and Part C and Part D payment policies. CMS will not publish a Call Letter for 2021. The Part D proposed rule would:
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Require Part D sponsors to disclose to CMS their pharmacy performance measures.
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Allow Part D plans to have up to two specialty tiers.
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Implement a new beneficiary real time benefit tool.
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Implement several SUPPORT Act provisions.
The advance notice:
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Adds certain opioids and antipsychotic use measures to the display page for 2021.
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Considers implementing PQA medication adherence measures in future Star Ratings measures.
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Includes plans to develop measures to assess generic and biosimilar utilization in Part D.
Finally, CMS states it will begin reporting an initial opioid prescribing measure in the Patient Safety reports for 2020. See NCPA summaries on the proposed rule, and advance notice for more information. NCPA is carefully analyzing the proposal and will be seeking member input prior to commenting by the March 6 (advance notice) and April 6 (Part D proposed rule) deadlines.
