CMS Clarifies Issuers Cannot Make Substitutions Within Prescription Drug Category

CMS confirms that its newly finalized rule letting issuers make benefit substitutions within and among the 10 essential health benefit categories if permitted by a state does not apply to the prescription drug benefit. States, however, may substitute an entire prescription drug category with one from another state. In finalizing the proposal allowing plan substitutions, CMS slightly amended the proposed version and now requires that a state notify HHS when it permits issuers to make changes. However, the rule indicates...