Lexology December 16, 2024
Sheppard Mullin Richter & Hampton LLP

On November 26, 2024, the Centers for Medicare & Medicaid Services (“CMS”) released the contract year 2026 proposed rule for the Medicare Advantage (“MA”) program, Medicare Prescription Drug Benefit Program (“Part D”), Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly (the “Proposed Rule”). Likely one of the last significant Medicare reform initiatives of the Biden administration, the Proposed Rule incorporates many of the Administration’s broader policy priorities, focusing on equity, transparency, and modernization in healthcare delivery and oversight.

We’ve summarized some of the key changes in the Proposed Rule. Comments are due January 27, 2025.

Expanding Part D Coverage: Anti-Obesity Medication and Covered Insulin Product

In response to the increasing prevalence of obesity and other considerations,...

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