CMS is hosting a November 14, 2016 “listening session” to obtain stakeholder input on implementation of section 704 of the Comprehensive Addiction and Recovery Act of 2016 (CARA), Under this provision, Medicare Part D sponsors may establish drug management programs for at-risk beneficiaries to limit access to frequently-abused drugs to certain prescribers and pharmacies. Topics for the call include, among others: clinical guidelines that indicate misuse or abuse of frequently abused drugs; the anticipated impact of drug management programs for at-risk beneficiaries on cost-sharing and accessibility to prescription drugs; the use of an expedited appeals regarding an enrollee’s identification as an at-risk beneficiary; drug plan sponsor implementation responsibilities; notification requirements; evidence-based prescribing guidelines for opiates; and the sharing of Part A and B claims data with Part D sponsors. CMS invites participation by Medicare beneficiaries and advocacy groups, pharmacies, plan sponsors, pharmacy benefit managers, and other interested parties.
