Benchmark: Medicare Proposed Rule 2026: Key Changes for Cost-Sharing, Provider Directories, and PBM Accountability
Take this benchmark to assess how much you would benefit from taking the course on CMS’s proposed rule implementing Sections 6219, 6220, and 6224 of the Consolidated Appropriations Act, 2026.
This quick check surfaces how well you grasp the rule’s intent, who it helps, and what will change for Medicare Advantage organizations, Part D sponsors, PBMs, providers, and beneficiaries.
Why take it?
- Clarify the policy goals behind $0 generic copays for the lowest-income dual eligibles and what that means for equity, adherence, and program costs.
- Gauge your readiness for the REAL Health Providers Act requirements: verification cadence, public accuracy scores, enrollee protections, and data standardization.
- Spot gaps in understanding PBM accountability: bona fide service fees, full pass-through of rebates, audit rights, and transparency trade-offs.
- Identify operational impacts and choices you’ll need to make (compliance vs. flexibility, access vs. admin burden, transparency vs. confidentiality).
- Decide where to focus your learning so you can comment effectively on the proposal and implement changes with less friction.
Result: You’ll see where deeper training can save rework, reduce compliance risk, and improve outcomes for beneficiaries and your organization.
NOTE: Unless otherwise indicated, all Benchmarks are free of charge!
