Federal Policy
CMS Proposes Rule on Part D Cost-Sharing, PBM Accountability
In a client alert, King & Spalding reports that CMS published a proposed rule on October 20, 2026 to implement three sections of the Consolidated Appropriations Act of 2026. The sections cover adjustments to Medicare Part D cost-sharing reductions for low-income individuals, requirements for enhanced and accurate provider directories, and pharmacy benefit manager accountability measures. The rule would amend existing Medicare Advantage, Part D, and PBM regulations.
Why it mattersPharmacy benefit managers and Medicare Advantage plans may need to review the proposed rule closely given its implications for cost-sharing, directory accuracy, and PBM oversight requirements.