Skip to main content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Ensuring Dual-Eligible Enrollees' Access to Drugs Under Part D: Mandatory Review

Dual-eligible enrollees are enrolled in both Medicaid and Medicare, and they receive prescription drug coverage under Medicare Part D. As long as Part D plans abide by certain limitations outlined in 42 CFR § 423.120, Part D sponsors have discretion to include different Part D drugs in their formularies. As required under section 3313 of the Patient Protection and Affordable Care Act, we will conduct an annual study of the extent to which formularies used by Medicare Part D plans include drugs commonly used by dual-eligible enrollees. This study will focus on Part D plans' 2025 formularies.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
February 2025 CMS Ensuring Dual-Eligible Enrollees' Access to Drugs Under Part D: Mandatory Review Office of Evaluation and Inspections OEI-05-25-00120 2025