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VA | RIN: 2900-AP35 | Publication ID: Spring 2017 |
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. Prior to this final rule, VA charged non-exempt veterans either $8 or $9 for each 30-day or less supply of medication, and that amount may have changed in future years. This rulemaking replaces those rates and establishes three classes of medications for copayment purposes, identified as Tier 1, Tier 2, and Tier 3. These tiers are defined further in the rulemaking and 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. For non-exempt veterans these copayment amounts will result in lower out-of-pocket costs, thereby encouraging greater adherence to taking prescribed medications and reducing the risk of fragmented care that results when veterans use non-VA pharmacies to fill their prescriptions. |
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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: Completed Actions |
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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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 Bridget Souza Deputy Director, Business Policy CBO Department of Veterans Affairs 90 K Street NE., Washington, DC 20002 Phone:202 382-2537 Email: bridget.souza@va.gov |