Regulations & Laws
Medicare Part D
The Medicare prescription drug benefit, delivered through private plans. Pharmacies that serve Part D patients must meet the compliance-program expectations CMS places on plan networks.
In depth
Established by the Medicare Modernization Act of 2003, Part D benefits are administered by private sponsors and their PBMs. CMS expects sponsors to operate effective compliance programs and to extend core requirements - such as FWA training and exclusion screening - to their network pharmacies. Participation also brings audit exposure and DIR-fee dynamics.