Medicare Program; Implementation of Sections 6219, 6220, and 6224 of the Consolidated Appropriations Act, 2026
Key claim: CMS proposes rules that would change Medicare Part D cost-sharing for low-income enrollees, require more accurate public lists of health providers, and add new accountability requirements for pharmacy benefit managers.
Abstract
(Proposed Rule · Health and Human Services Department, Centers for Medicare & Medicaid Services) This proposed rule would implement section 6219 (Adjustments to Medicare Part D Cost-Sharing Reductions for Low-Income Individuals), section 6220 (Requiring Enhanced and Accurate Lists of (REAL) Health Providers Act), and section 6224 (Modernizing and Ensuring Pharmacy Benefit Manager Accountability) of the Consolidated Appropriations Act, 2026.
Why this matters
This proposed rule is the operational step that turns three Consolidated Appropriations Act, 2026 provisions into enforceable Medicare requirements — adjusting what low-income Part D enrollees pay, how accurately plans must list in-network providers, and how PBMs are held accountable. Because it is a proposed rule, specifics may shift before finalization, but it signals the direction CMS intends for Part D cost-sharing and PBM oversight.