CMS Proposes Rule on Part D Cost-Sharing, PBM, Provider Directory Rules
CMS has issued a proposed rule to implement three provisions of the Consolidated Appropriations Act, 2026: section 6219, adjusting Medicare Part D cost-sharing reductions for low-income individuals; section 6220, the REAL Health Providers Act requiring more accurate provider directory listings; and section 6224, imposing new pharmacy benefit manager accountability and transparency requirements. The rule primarily affects Medicare Part D plans, pharmacy benefit managers, and providers listed in plan directories. CMS has opened a comment period on the proposal, though the document does not specify a comment deadline or effective date. The rule matters because it reshapes PBM oversight and provider directory accuracy standards that often parallel requirements Medicaid managed care plans and state agencies also follow.