CMS Issues Letter to Insurance Plans and PBMs
On Dec. 14, 2023, the Centers for Medicare & Medicaid Services (CMS), released a signed letter to pharmacy benefit managers (PBMs), Medicare Part D Plans, Medicaid-managed care plans and private insurance plans, outlining concerns it has about “certain practices by some plans and pharmacy benefit managers (PBMs) that threaten the sustainability of many pharmacies, impede access to care and put increased burden on health care providers.”
CMS said it was particularly concerned about the sustainability of small and independent pharmacies, which can leave pharmacy services out of reach for people in rural and underserved areas if they close. CMS also said it was “very concerned” about payment practices that may “impede access to recommended vaccinations and it is imperative that plans and PBMs take immediate steps to ensure adequate payment for and access to vaccines.”
Read CMS’ full letter here.