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DashboardRegulations DirectoryRequest for Information; Medicare Part D Reasonable and Relevant Pharmacy Contracting Standards
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Request for Information; Medicare Part D Reasonable and Relevant Pharmacy Contracting Standards

Authentic statutory obligations decomposed into atomic machine-actionable conditions, actions, and verification standards.

Official Legal Text
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Approved

Article 1860D-: 4(b)(1)(A) of the Social Security Act (the Act) to require Part D plan sponsors

section 1860D- 4(b)(1)(A) of the Social Security Act (the Act) to require Part D plan sponsors to permit any pharmacy that meets standard contract terms and conditions under the plan to participate as a network pharmacy of the plan. Section 6223(a) of the CAA, 2026 further requires that, notwithstanding any other provision of law, for plan years beginning January 1, 2029, such standard contract te...

Required Actions & Enforcement

Action Type:AUTOMATED_COMPLIANCE_VERIFY

Trigger Conditions (AST Logic)OP: AND

control.1860D-.implementedEQUALStrue
system.audit.activeEQUALStrue