Narrow Networks 2017: Will Narrow Pharmacy Networks Evolve from Reduce-Reimbursement to Performance Networks?

Wayne Miller

Part D Sponsors to the Medicare Part D program must ensure that their retail pharmacy networks meet the convenient access criteria established under 42 CFR §423.120. These metrics stem directly from the statutory requirement that Medicare Part D sponsors’ entire retail pharmacy networks meet the TRICARE standard for convenient access: Sponsors and applicants must ensure that their networks have a sufficient number of pharmacies able to dispense drugs directly to patients (other than by mail order) to ensure convenient access to Part D drugs. CMS rules require that sponsors establish retail pharmacy networks in which: Read more

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Are You Ready for the Medicare Advantage Advance Notice & Draft Call Letter?

Olga Walther

As you may recall, in December 2015, the Securing Fairness in Regulatory Timing Act extended the 45-day notice …

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Marketing and Sales Return on Investment (ROI) – What Is the Data Telling You?

Carrie Barker-Settles
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Getting a Jump Start on Measures

Melissa Smith

Every January, we return from the holidays facing a Star Ratings conundrum. We must decide how much to …

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Pharma Shakedown ‒ What’s Next for Part D?

Olga Walther

Most of the attention on drug pricing quickly fizzled when President-Elect Donald Trump partnered with Speaker Paul Ryan …

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Opportunities for Growth in the New Administration

Diane Hollie

“Opportunities are like sunrises. If you wait too long, you miss them.” ―William Arthur Ward 

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What Trump Could Actually Do to ObamaCare, Day One, Without Congress

John Gorman

It’s becoming clear here in DC that legislative repeal of ObamaCare may actually not happen. As many as …

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