It is inevitable that the Biden administration would review and make changes to the Part D drug pricing agenda set forth by the Trump administration and those changes are coming rapidly. A prior Part D Payment Modernization proposal of allowing Part D Plans to offer fewer drugs per category and class for the six "protected classes" has been ended. The formulary flexibilities would have been part of 2022 applications for a the Part D Payment Modernization model. CMS' Center for Innovation said they ultimately decided against that piece of the proposal due to advocates and providers' concerns that beneficiaries could be negatively impacted.
One thing is for certain, more changes will be coming related to Part D drug pricing. Applications to take advantage of other provisions in the payment model are still due to CMS April 16, 2021.
