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VA | RIN: 2900-AP35 | Publication ID: Fall 2016 |
Title: Tiered Pharmacy Copayments for Medications | |
Abstract:
The Department of Veterans Affairs (VA) adopts as a final rule, with changes, a proposal to amend its regulations concerning copayments charged to certain veterans for medication required on an outpatient basis to treat nonservice-connected conditions. This rulemaking establishes three classes of medications for copayment purposes, identified as Tier 1, Tier 2, and Tier 3. These tiers are distinguished in part based on whether the medications are available from multiple sources or a single source, with some exceptions. Copayment amounts are fixed and would vary depending upon the class of medication. The following medication copayment amounts are applicable on the effective date of this final rule: $5 for a 30-day or less supply of a Tier 1 medication, $8 for a 30-day or less supply of a Tier 2 medication, and $11 for a 30-day or less supply of a Tier 3 medication. |
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Agency: Department of Veterans Affairs(VA) | Priority: Economically Significant |
RIN Status: Previously published in the Unified Agenda | Agenda Stage of Rulemaking: Final Rule Stage |
Major: Yes | Unfunded Mandates: No |
CFR Citation: 38 CFR 17.110 | |
Legal Authority: 38 U.S.C. 501 |
Legal Deadline:
None |
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Statement of Need: This rulemaking will result in lower out-of-pocket costs for most veterans, thereby encouraging greater adherence to prescribed medications and reducing the risk of fragmented care that results when veterans use multiple pharmacies to fill their prescriptions. |
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Summary of the Legal Basis: 38 U.S.C. 501 |
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Anticipated Costs and Benefits: |
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Risks: |
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Timetable:
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Regulatory Flexibility Analysis Required: No | Government Levels Affected: None |
Small Entities Affected: No | Federalism: No |
Included in the Regulatory Plan: Yes | |
RIN Data Printed in the FR: No | |
Agency Contact: Kristin Cunningham Chief, Business Office (16) Department of Veterans Affairs Veterans Health Administration, 810 Vermont Avenue NW., Washington, DC 20420 Phone:202 461-1599 Email: kristin.cunningham@va.gov |