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GAO-17-335R 1 (2016-12-28)

handle is hein.gao/gaobadsys0001 and id is 1 raw text is: G A U.S. GOVERNMENT ACCOUNTABILITY OFFICE 441 G St. N.W. Washington, DC 20548 B-328692 December 28, 2016 The Honorable Johnny Isakson Chairman The Honorable Richard Blumenthal Ranking Member Committee on Veterans' Affairs United States Senate The Honorable Jeff Miller Chairman The Honorable Mark Takano Acting Ranking Member Committee on Veterans' Affairs House of Representatives Subject: Department of Veterans Affairs: Tiered Pharmacy Copayments for Medications Pursuant to section 801 (a)(2)(A) of title 5, United States Code, this is our report on a major rule promulgated by the Department of Veterans Affairs (VA) entitled Tiered Pharmacy Copayments for Medications (RIN: 2900-AP35). We received the rule on December 15, 2016. It was published in the Federal Register as a final rule on December 12, 2016. 81 Fed. Reg. 89,383. The final rule amends regulations concerning copayments charged to certain veterans for medication required on an outpatient basis to treat nonservice-connected conditions. The final rule establishes three classes of medications for copayment purposes, identified as Tier 1, Tier 2, and Tier 3. These tiers are distinguished in part based on whether the medications are available from multiple sources, or a single source, with some exceptions. The following copayment amounts are fixed and would vary depending upon the class of medication: $5 for a 30-day or less supply of a Tier 1 medication, $8 for a 30-day or less supply of a Tier 2 medication, and $11 for a 30-day or less supply of a Tier 3 medication. According to VA, for non-exempt veterans these copayment amounts will result in lower out-of-pocket costs, thereby encouraging greater adherence to taking prescribed medications and reduce the risk of fragmented care that results when veterans use non-VA pharmacies. The final rule is effective on February 27, 2017. Enclosed is our assessment of VA's compliance with the procedural steps required by section 801(a)(1)(B)(i) through (iv) of title 5 with respect to the rule. Our review of the procedural steps taken indicates that VA complied with the applicable requirements. GAO-17-335R

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