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GAO Report: CMS Conducts Oversight of Mid-Year Changes to Medicare Part D Formularies; Most Were Enhancements
U.S. Government Accountability Office [GAO] Link to more items from this source
Aug. 1, 2011
19 pages. "Sponsors also vary in the content of their formularies -- the list of covered drugs and associated utilization management (UM) requirements. UM requirements include [1] step therapy, which requires that a beneficiary try lower-cost drugs before a sponsor will cover a more costly drug; [2] prior authorization, which requires a beneficiary to obtain the sponsor's approval before a drug is covered for that individual; and [3] quantity limits, which restrict the dosage or number of units of a drug provided within a certain period of time." [GAO-11-366R, published Jun. 30, 2011, released Aug. 1, 2011]

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