On Thursday, the Centers for Medicare and Medicaid Services (CMS) issued its much anticipated final Medicare Advantage and Medicare Part D Drug Pricing Rule (CMS-4180-F). At this time, CMS has decided not to include much needed reforms of Direct and Indirect Remuneration (DIR) fee practices.

On March 7, 2019, the Centers for Medicare & Medicaid Services (CMS) announces plans to consolidate the competitive bidding areas (CBAs) included in the Round 2 Recompete and Round 1 2017 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program into a single round of competition named Round 2021. Round 2021 contracts are scheduled to become effective on January 1, 2021, and extend through December 31, 2023.

The proposed regulation would exclude rebates from safe harbor protections that currently protect drug manufacturers’ rebates from penalties under the federal Anti-Kickback Statute, and would create a new safe harbor for discounts offered direct to patients, as well as fixed-fee service arrangements between drug manufacturers and PBMs.

Illinois House Majority Leader Greg Harris is pushing hard for the “Prescription Drug Affordability & Accessibility Act HB 465

As outlined in California's State Plan Amendment 17-002, DHCS is implementing a new FFS reimbursement methodology for covered outpatient drugs. Barring unforeseen delay, DHCS anticipates FFS pharmacy providers will see the new reimbursement methodology reflected in their claims with dates of service starting February 23, 2019. Because the policy effective date mandated by CMS is April 1, 2017, DHCS intends to make retroactive adjustments for all claims with dates of service between April 1, 2017, and the implementation date.

IPC’s Government Relations team encourages members in the Texas area to attend the Texas Pharmacy Day at the Capital. The event will take place Tuesday, February 26th at First United Methodist Church in Austin, Texas. Presented by the Alliance of Independent Pharmacists of Texas, the goal is to unite multiple independent pharmacy interests on legislative and regulatory issues, while promoting the profession. Register online at www.aiptexas.org today!