CY 2026 PDPFS Reference Data Pull Dates: Appendix B Schedule
Relevant to: PDP, Drug Pricing
Each week, we scan the latest CMS memos to find the most important ones that apply for PACE programs. Below is a summary of what you need to know.
Disclaimer: The content provided on this site is a summary for informational purposes only, and Grane PBM, Inc. assumes no liability for any errors or omissions in the site’s content. The information does not constitute legal or regulatory advice or replace the original CMS memo. Readers are advised to consult the CMS memo in its entirety and to verify information independently before making any decisions based on this information.
Introduction
The CY 2026 PDPFS and MPF schedules are out, offering essential timelines for submission windows, posting dates, and the relevant formulary and benefit data. From June 2025 to September 2026, crucial dates are outlined to ensure timely submission and accurate data usage. Keeping these dates in mind is vital for adhering to the regulations and ensuring data accuracy in drug pricing submissions.
Key Dates and Deadlines
- PDPFS Submission Window #1: June 30, 2025 – July 11, 2025
- Use Formulary Data as of June 1, 2025 (Window #1)
- PDPFS Submission Window #2: July 21, 2025 – August 1, 2025
- Use Formulary Data as of July 1, 2025 (Window #2)
- PDPFS Submission Window #3: August 11, 2025 – August 22, 2025
- Posting Date: October 1, 2025
- Use Formulary Data as of September 1, 2025 (Window #4)
- Final Posting Date: September 7, 2026
PACE Compliance
This memo is relevant to PACE programs mainly due to the importance of aligning prescriptions and formularies with updated pricing data and compliance requirements for a continuous cycle of the Program of All-Inclusive Care for the Elderly. The calendar outlined in the appendix provides crucial submission and posting dates that help PACE organizations in planning their formulary submissions and updates efficiently.
To comply with PACE guidelines:
- PACE plans must ensure that their formularies align with the prescribed dates for formulary and benefit data updates. This means that any changes in the drug pricing or benefits should be prepared and submitted in accordance with the submission windows provided.
- Organizations should use the most recent submitted data during the listed drug pricing submission windows. Especially during the specified test windows, it is crucial to ascertain that the data used is current and compliant to avoid discrepancies in pricing.
- Compliance with the Medicare Plan Finder (MPF) timeline is important as non-compliance may result in incorrect plan information becoming public, ultimately impacting PACE enrollees negatively.
It is imperative for PACE organizations to be aware of the key dates and ensure data submission aligns with these checkpoints to uphold compliance and maintain service quality for the elderly.
Required Actions
Appendix B outlines key dates and processes for the CY 2026 PDPFS and CY 2026 MPF, which involve utilizing approved formulary and benefit data.
FAQs
- “What are the key dates for the CY 2026 PDPFS process?”
- “How is the submission window for CY 2026 PDPFS structured?”
- “When must approved formulary and benefit data be ready for CY 2026?”
- “What is the significance of test windows in the CY 2026 PDPFS schedule?”
- “How does the CMS use the data from submission windows for drug pricing?”
