37 pages. "This year's letter includes a new subsection, 'Coverage of OTC Drugs, Products, and Supplies' to incorporate related guidance based on Carrier Letter 2024-18. Additionally, this letter clarifies policies on formulary management, utilization management, pharmacy network management, specialty drug management, medication management, opioids, member experience and transparency, cost containment, Medicare benefits, data, and population health. Within formulary management, OPM clarifies policies on formulary decision-making, formulary exceptions, formulary designs, new- to-market drugs, biosimilars, formulary reviews, and mid-year formulary changes. Within population health, OPM clarifies policies on tobacco cessation, preventive services, contraception, fertility benefits, coronavirus disease 2019 (COVID-19), and anti-obesity medications. Additionally, within population health, OPM has removed the subsection on gender affirming care and services." MORE >>