CMS issues proposals to improve MA plan provider directory accuracy, PBM transparency requirements and reduce drug costs 

The Centers for Medicare & Medicaid Services released a proposed rule Oct. 16 seeking to codify regulations that will improve the accuracy of Medicare Advantage plan provider directories, establish transparency and compensation requirements for pharmacy benefit managers and their affiliates, and reduce copayments for generic drugs to $0 for low-income Medicare Part D beneficiaries. Among the proposed rule’s provisions, it would require MA plans to verify and update their provider directory information at least every 90 days and report to CMS an accuracy score, which would also be displayed publicly on the plans’ public-facing directories. CMS is accepting comments on the proposed rule through Dec. 15, 2026. The agency said it anticipates releasing another proposed rule on policy and technical changes for MA and Part D later this fall.