Call Letter Archives - Applied Policy

CMS Proposes Adding Second Specialty Tier Option to Part D, Additional Opioid Drug Management Programs; Call Letter Includes Technical Updates

CMS has released a proposed rule that would update program policies for Medicare Advantage and Medicare Part D beginning in 2021, if finalized. CMS has also released the draft Call Letter for 2021; however, this year’s Call Letter is limited to standard benefit parameters, risk-sharing, and other technical details and does not feature any additional [...] Read More

CMS Lets Plans off With a Warning Regarding Generics, But Increased Out-of-Pocket Threshold for 2020 Looms Large

On April 1, 2019, CMS released the final Medicare Advantage and Part D Call Letter for the 2020 plan year. While the Call Letter itself was relatively quiet, compared to other Administration activities around the two benefits, CMS pulled back on a proposal to limit plan sponsors from placing generic drugs on tiers labeled “brand” [...] Read More

Proposals for 2020 Medicare Advantage and Part D Plans Released, Opioids and Generic Access Continue to be a Focus

The Center for Medicare and Medicaid Services (CMS) has released the plan year 2020 Draft Call Letter outlining proposed changes to policies impacting Medicare Advantage (MA) and Part D prescription drug plans (PDPs). The agency is continuing to focus on changes that will modernize the MA and PDP benefits to make the plans operate closer [...] Read More

CMS Releases Final CY 2019 Call Letter, Finalizes New Strategies for Opioid Policy, Updates Standard Benefit Parameters to Account for New Coverage Gap Rules

On April 2, 2018 CMS released the final CY 2019 Call Letter for Medicare Advantage (MA) and Medicare Part D plans. There were no substantial changes to the proposals included in the draft Call Letter, which were finalized generally as proposed. However, the agency did have to update the Standard Benefit Parameters to reflect the […]

CMS Finalizes Call Letter with Few Changes, Issues Open Request for Information from Stakeholders on Ways to Improve Medicare Advantage, Part D

On Monday, April 3, 2017, the Centers for Medicare and Medicaid Services (CMS) issued the final Call Letter for the 2018 Medicare Advantage and Medicare Part D Prescription Drug Benefit plan year. The Call Letter establishes requirements for Medicare Advantage (MA) and Medicare Part D plan sponsors for the 2018 benefit year. The draft call […]

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