Revising the Medicare Model Guidelines

The Medicare Modernization Act designates USP to develop the Model Guidelines and "to revise such classification from time to time to reflect changes in therapeutic uses of covered part D drugs and additions of new covered part D drugs." The links below provide additional information regarding USP's approach to the revision process.

Revisions to the USP Medicare Model Guidelines

Model Guidelines Version 4.0 - Applicable to formularies designed for the 2009 through 2011 benefit years.

Model Guidelines and Formulary Key Drug Types Version 4.0 (25KB)
Model Guidelines and Formulary Key Drug Types Version 4.0 (Excel) (46KB)
Summary of Approach and Methodology (88KB)
Attachment: Summary of Public Comments (102KB)
Model Guidelines Expert Committee Meeting Summaries:
- Meeting #10 – April 17, 2007 (80KB)
- Meeting #11 – August 6, 2007 (57KB)
- Meeting #12 – October 1, 2007 (39KB)
Drug List Table (88KB)
Drug List Table (Excel) (144KB)

Model Guidelines Version 3.0 – Applicable to formularies designed for the 2008 benefit year.

Model Guidelines and Formulary Key Drug Types Version 3.0 (25KB)
Model Guidelines and Formulary Key Drug Types Version 3.0 (Excel) (46KB)
Summary of Approach and Methodology (115KB)
Model Guidelines Expert Committee Meeting Summaries:
- Meeting #6 – March 28, 2006 (65KB)
- Meeting #7 – August 21, 2006 (105KB)
- Meeting #8 – November 8, 2006 (91KB)
- Meeting #9 – January 9, 2007 (244KB)
Drug List Table (87KB)
Drug List Table (Excel) (139KB)