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CMS Proposes Update to Simplified Prescription Drug Creditable Coverage Determination Methodology
Groom Law Group 
[Guidance Overview] Feb. 4, 2025 "CMS proposes to revise the simplified methodology to consider prescription drug coverage to equal or exceed the actuarial value of the defined standard Part D benefit -- and, therefore, to be creditable -- if it meets all of the following: [1] Provides reasonable coverage for brand name and generic prescription drugs and biological products; [2] Provides reasonable access to retail pharmacies; and [3] Is designed to pay on average at least 72% of participants' prescription drug expenses." MORE >> |
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