Part B Insider (Multispecialty) Coding Alert

Formulary Leaves Out Crucial Drugs

The guidelines for the drug formulary in next year's Medicare prescription drug benefit could force patients to pay out of pocket for expensive drugs. The American Medical Association, the American College of Physicians and other groups raised concerns that the U.S. Pharmacopeial Convention's recommendations contain too few categories of drugs that are thus too broad. Drug plans must cover two drugs in each "class" of medicines to gain Medicare approval.

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