CMS Proposes Letting Exchange Plans Change Formularies Mid-Year

CMS proposed letting exchange plans change formularies mid-year to speed generic drug uptake, the agency announced Thursday (Jan. 17). The proposed rule also gives insurers greater authority to prohibit the costs of brand drugs and manufacturer coupons from counting toward patients’ out-of-pocket spending limits when patients choose brands over generics, which bolsters the copay accumulators that brands and patient advocates hate. The policies stem from the administration’s drug-pricing blueprint. The proposed changes were included in the administration’s 2020 Notice of...