PART D: Plan Formularies Fail To Provide Dual Eligibles With Access To Critical Meds

Why This Topic Matters

It highlights how formulary design and coverage policy can affect vulnerable beneficiaries who are transitioning between Medicaid and Medicare. Readers can use it to understand the general policy and administrative issues behind Part D drug access and the role of federal oversight.

Article Sections

1. Broad Distribution Among Formularies Dilutes Drugs' Availability

   Discusses the overall distribution of drug coverage across Medicare Part D formularies and how coverage varies among plans and regions. It also describes general transition-related safeguards available to beneficiaries.

2. Statutory Exclusions Keep Some Drugs Under Medicaid

   Covers the article’s discussion of excluded drug categories and how state Medicaid programs may continue to provide coverage for some affected drugs. It also summarizes the scope of state-level coverage mentioned in the report.

3. CMS Challenges OIG's Scope And Methodology

   Summarizes CMS’s response to the OIG report, including concerns about the report’s methodology and the agency’s separate analysis of formulary coverage.