US · guidance
CMS Pub. 100-18, ch. 12, § 20.14
Part D Formularies
PDP sponsors will not be required to submit to CMS every formulary variation offered to Part
D eligibles enrolled in EGWPs. Rather, PDP sponsors are permitted to submit a base
formulary for use with its employer/union sponsored group health plans. After submission
and approval of a base formulary, PDP sponsors may enhance the formulary (add new drugs
or make positive changes to cost sharing) without having to resubmit the formulary for review
and approval by CMS. These formularies may not be modified to remove any drugs from the
list, or to add any restrictions or limitations unless these modifications or removals are
otherwise consistent with CMS requirements.
History
(Rev.6, Issued: 11-07-08, Effective/Implementation: 11-07-08)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-09-17
- Edition
- iom-2026-09-17
- Content hash
030fe2b3d217a3fea931248c10c22ac2a51d95ed83e45541aa1aef4d4a7d25cd
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