The Consolidated Appropriations Act (CAA) requires group and individual health plans to report annual data about prescription drugs and health care spending to the Center for Medicare & Medicaid Services (CMS). The last day to submit this data to CMS for the 2024 reference year is June 1, 2025.

The year is off to an exciting start! As a pharmacy partner, we consistently monitor market trends to ensure our programs and solutions meet the specific needs of our groups.

The Centers for Medicare and Medicaid Services (CMS) recently approved New York's Managed Care Organization tax (MCO), effective 1/1/2025. This tax, authorized by the 2024-2025 State Budget, will apply different tax rates to Medicaid and non-Medicaid plans. The tax rates are based on per member per month enrollment and will apply on a calendar year basis.