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Trump administration proposal would allow Part D plans to negotiate prices of drugs in 'protected' classes

November 26, 2018 / Tina Reed

The Trump Administration's latest proposed rule aimed at curbing prescription drug prices would allow Medicare Part D plans to negotiate better prices in "protected" classes. “Certain CMS regulations constrain these plans’ full negotiating power and the changes that we’re proposing would remove barriers that prevent MA and Part D plans from taking advantage of approaches to lowering prescription drug costs that are widely used by private plans,” Centers for Medicare & Medicaid Services Administrator Seema Verma said in a call with reporters after announcing the proposed rule on Monday evening. Verma said the proposals would create certain exceptions to current constraints on protected drugs, allowing Part D sponsors broader use of prior authorization and step therapy—a flashpoint between insurers and providers. It would also allow plans to exclude from their formularies protected class drugs that have price increases that are greater than...