Real-time drug pricing access rule to take effect

HHS announced prescription drug reforms are set to take effect Oct. 1, designed to give patients and physicians real-time access to prescription drug costs, insurance coverage details and prior authorization requirements. 

The rule was issued in July as part of CMS Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System final rule. It will require healthcare providers to use certified health IT systems to electronically submit prior authorization requests, check on drug prices during appointments and share prescription information with pharmacies and insurers, according to a Sept. 2 news release from the agency. 

The change comes after a June roundtable involving HHS Secretary Robert F. Kennedy Jr., CMS Administrator Mehmet Oz, MD, Medicare Director Chris Klomp and representatives from major insurers. 

Insurers agreed to six reforms to improve transparency and reduce red tape across Medicare Advantage, Medicaid Managed Care, Medicare Part D, ACA Marketplace and commercial plans, the release said. 

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