HHS releases drug coverage rules

11/21/2012 | Politico Pro (subscription required)

Under proposed rules issued Tuesday, insurers would have to cover at least one drug in each class or the same number covered under the state's benchmark, whichever is greater. However, HHS rejected requests to cover all drugs in six so-called protected classes. "When plans have more flexibility to design clinically based formularies, they can negotiate bigger price concessions from drug makers and offer more affordable, generous prescription drug benefits to patients," Pharmaceutical Care Management Association President and CEO Mark Merritt said.

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