Stream: Da Vinci PDex Drug Formulary
Topic: Group Plans
Mark Neumuth (Feb 24 2021 at 15:40):
CoveragePlans that an organization sponsors might only be available to that organization's members and proprietary to the sponsoring organization and the Payer. With the shopping experience for Formulary APIs, are we required to show group plans? In case we are required to show group plans for shopping, which search parameter would restrict the search to a particular organization?
Saul Kravitz (Mar 02 2021 at 19:38):
Hi @Mark Neumuth . By "required" do you mean by the CMS rule(s)?
Mark Neumuth (Mar 03 2021 at 13:47):
Hello @Saul Kravitz . Correct...does CMS require that payers provide members with group plan information? I don't believe so based on last Friday's PDex call but would like to confirm. Thank you! @Raj Sankuratri @Courtney Bland
Saul Kravitz (Mar 03 2021 at 14:55):
The shopping experience is not covered by CMS rules.
Last updated: Apr 12 2022 at 19:14 UTC
