Pharmacy benefit managers: regulatory and accreditation changes
Related IHS services: URAC PBM Accreditation Consulting · New York PBM License Readiness Consulting
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CMS Proposes Reforms to Strengthen Transparency & Affordability in Medicare Advantage and Part D
· Centers for Medicare & Medicaid Services
Centers for Medicare & Medicaid Services states: “CMS issued a proposed rule that would improve the accuracy of provider directories for Medicare Advantage plans, establish transparency and compensation requirements for Pharmacy Benefit Managers, and deliver enhanced cost-saving protections for low-income Medicare beneficiaries.”
Related IHS services: Medicare Advantage and Part D Compliance Program and FDR Oversight Consulting · URAC Medicare Advantage Organization Accreditation Consulting
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· Centers for Medicare & Medicaid Services
Full title: Medicare Program; Implementation of Sections 6219, 6220, and 6224 of the Consolidated Appropriations Act, 2026 (Proposed rule; FR Doc. 2026-21420)
Centers for Medicare & Medicaid Services states: “This proposed rule would implement section 6219 (Adjustments to Medicare Part D Cost-Sharing Reductions for Low-Income Individuals), section 6220 (Requiring Enhanced and Accurate Lists of (REAL) Health Providers Act), and section 6224 (Modernizing and Ensuring Pharmacy Benefit Manager Accountability) of the Consolidated Appropriations Act, 2026.”
Related IHS services: Medicare Advantage and Part D Compliance Program and FDR Oversight Consulting
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CMS Proposes Reforms to Strengthen Transparency and Affordability in Medicare Advantage and Part D
· Centers for Medicare & Medicaid Services
Centers for Medicare & Medicaid Services states: “The Centers for Medicare & Medicaid Services (CMS) today issued a proposed rule that would improve the accuracy of provider directories for Medicare Advantage plans, establish transparency and compensation requirements for Pharmacy Benefit Managers (PBMs), and deliver enhanced cost-saving protections for low-income Medicare beneficiaries.”
Related IHS services: Medicare Advantage and Part D Compliance Program and FDR Oversight Consulting · URAC PBM Accreditation Consulting · URAC Medicare Advantage Organization Accreditation Consulting · New York PBM License Readiness Consulting
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