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Medicare Modernization Act Final Guidelines-Formularies CMS Strategy for Affordable Access to Comprehensive Drug Coverage: Guidelines for Reviewing Prescription Drug Plan Formularies and Procedures

January 28, 2005 Medicare Modernization Act Final Guidelines-Formularies CMS Strategy for Affordable Access to Comprehensive Drug Coverage: Guidelines for Reviewing Prescription Drug Plan Formularies and Procedures This paper is final guidance on how CMS will review Medicare prescription drug benefit plans to assure that beneficiaries receive clinically appropriate medications at the lowest possible cost. Two key requirements in the Medicare Modernization Act (MMA) are to assure that drug plans provide access to medically necessary treatments for all and do not discriminate against any particular types of beneficiaries, and to encourage and support the use of approaches to drug benefit . . .

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