CMS proposes rule on provider directories and pharmacy benefit managers
The draft rule would put key provisions from a February government funding package into effect, with most reforms starting in 2028.
By Standard Topic. AI-generated from the reporting listed under Coverage. Published . Updated .
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What happened
The Centers for Medicare & Medicaid Services issued a draft regulation covering provider directories and pharmacy benefit managers, known as PBMs. The proposed changes would implement key healthcare provisions passed by Congress in a government funding package from February. The brunt of the reforms would take effect in 2028.
Why it matters
The rule would clean up Medicare Advantage provider directories and bring more transparency to PBMs. The reforms would take effect mainly in 2028.
Timeline
- Oct 16, 8:00 PM ET: CMS issued a draft regulation on provider directories and the PBM transparency rule.
- Oct 19, 9:04 AM ET: CMS proposed the rule to clean up Medicare Advantage provider directories and shed light on PBMs.
Coverage
- CMS proposes rule to clean up MA provider directories, shine light on PBMs (Rebecca Pifer Parduhn)
- CMS issues provider directory, PBM transparency rule (modernhealthcare.com)
- CMS proposes MA 'ghost network,' PBM transparency requirements (fiercehealthcare.com)
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