As discussed in a previous blog post, CMS released guidance to prevent duplicate payments for drugs that Part D beneficiaries receive while in hospice. The new rule, which required Part D plans to place prior authorizations on all drugs for beneficiaries in hospice, received strong criticism. Those against the rule argued that prior authorizations would delay and reduce access to necessary drugs for beneficiaries in hospice care.
Last week, CMS revised the rule so that prior authorization is only required for pain relievers, anti-nauseants, laxatives, and anti-anxiety drugs. These drugs are generally associated with hospice treatment and should be covered by the fixed rate payments made to hospices. Part D plans will cover other drugs without additional prior authorization so that beneficiaries can have access to their medications.