CMS Proposes Updates to Medicare Advantage and Part D Coverage


The Centers for Medicare and Medicaid (CMS) has issued 298 pages of proposed revisions to the Medicare Advantage program and prescription drug benefit program (Part D) that would implement new benefits under the Patient Protection and Affordable Care Act (PPACA) and increase patient protections.  The proposals would codify provisions providing new benefits including the 50 percent discount on covered brand name drugs in the Part D coverage gap known as the “donut hole” as well as new tools to fight fraud and abuse in Medicare and improve patient protections.

Once final, the proposed rule will be effective for calendar year 2013 operations.  CMS will accept comments from all stakeholders through the close of business 60 days following the publication of the proposed rule in the Federal Register (scheduled for Oct. 11, 2011).  The full text can be found at

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