The rules reach MA-PD plans and $133,000,000 is appropriated
What the document says“``(G) Requirements relating to pharmacy benefit managers.--For plan years beginning on or after January 1, 2028, section 1860D-12(h).''.”
Section 6224 applies the new subsection to MA-PD plans through section 1857(f)(3) of the Social Security Act, for plan years beginning on or after January 1, 2028, and provides that chapter 35 of title 44 does not apply to its implementation. It appropriates $113,000,000 to the Centers for Medicare and Medicaid Services Program Management Account and $20,000,000 to the Inspector General of the Department of Health and Human Services, each for fiscal year 2026 and to remain available until expended.
What the document actually says“``(G) Requirements relating to pharmacy benefit managers.--For plan years beginning on or after January 1, 2028, section 1860D-12(h).''.”
For plan years that start on or after January 1, 2028, one more rule applies. It is the one set out above.
The rules first covered stand-alone drug plans. This brings in the bigger plans that include drug coverage. Money for the work is set out too.
No action is recorded against this proposal. That is not evidence that none has been taken, and nobody has yet read it against the record. See what the tracker does not yet cover.