Medical Economics November 26, 2024
Proposals would require more public data on prior authorization processes and whether those advance health equity.
Prior authorizations, vertical integration in health care organizations, and transparency for pharmacies all are part of the proposed rule for the 2026 Medicare contract year.
The U.S. Centers for Medicare & Medicaid Services (CMS) made a splash across health care with the proposal to cover effective but expensive antiobesity medications. That was not the only change pitched for 2026 for Medicare Advantage (Part C) and Medicare Prescription Drug Benefit Program (Part D) drug coverage.
CMS is seeking public comments on its proposals, with responses due Jan. 27, 2025. The proposed rule was announced Nov. 26, but it was unclear whether the CMS regulations published...
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