This webinar is intended for Medicare Part D plan leaders, actuaries, pharmacy and rebate strategy teams, policy and compliance professionals, and health plan executives seeking to understand the practical implications of the proposed GUARD Model.
Learning Objectives:
- Describe which categories of Medicare Part D drugs are expected to be impacted under the GUARD Model and how CMS defines the scope of included drugs, including outpatient prescription drugs dispensed through retail, mail order, home infusion, and long-term care pharmacies.
- Explain the ZIP code–based geographic logic, including how CMS proposes to randomly select geographic areas and limit model participation to beneficiaries living in those locations.
- Assess the potential impacts to Medicare Part D plans, including rebate calculations, pricing strategy, administrative complexity, and longer-term financial considerations as CMS tests this new payment approach.
