The Center for Medicaid & Medicare Services (CMS) recently released new guidelines that will affect the Medicare drug price negotiation process beginning in 2026.
In this episode ofComplications: Health Policy Unraveled, host Stephanie Kennan provides a summary of the new CMS guidelines, including the new requirements for drug manufacturers and Part D dispensing entities, the timeline for negotiating new drug prices, and some of the challenges in navigating these new guidelines. Tune in to learn more about these new CMS guidelines.
Name: Stephanie Kennan
Title: Senior Vice President, Federal Public Affairs at McGuireWoods Consulting
Specialty: Stephanie Kennan helps clients navigate the legislative and executive branches of the federal government to solve problems involving a variety of healthcare policy issues. Her work focuses on providers, medical device manufacturers, drug manufacturers and associations concerned about Medicare and Medicaid reimbursement.
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[0:30] An overview of the new CMS drug price negotiation guidelines
[1:21] The limited effect of the Inflation Reduction Act on Medicare drug price negotiations
[1:39] The process of negotiating new maximum fair prices for drugs between Medicare and drug manufacturers.
[3:18] How the new guidelines mandate patient access to drugs
[5:28] Using a Medicare Transaction Facilitator to ensure the guidelines are followed by engaging in an exchange of information between drug manufacturers and CMS
[7:02] CMS’s procedures for receiving feedback on certain features of the new guidelines
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