{
  "name": "partd-formulary-network-mcp",
  "title": "HealthMesh · Medicare Part D Formulary (SPUF) MCP",
  "version": "0.1.1",
  "description": "Medicare Part D formulary coverage from the CMS quarterly Prescription Drug Plan Formulary, Pharmacy Network and Pricing PUF (SPUF): tier, quantity limit, prior authorization and step therapy for a drug (RxCUI, NDC or name) on any Part D plan; UM comparison across plans by state; 2023-2026 formulary trends; plan average unit costs by NDC. Pharmacy network rows are not loaded.",
  "healthmesh_domain": "Utilization Management",
  "datasets": [
    "UM-07",
    "RX-06"
  ],
  "mcp_endpoint": "https://partd-formulary-network.healthmesh.ai/mcp",
  "transport": "Streamable HTTP (stateless, JSON responses)",
  "authorization": "none",
  "auth_mode": "off",
  "docs": "https://github.com/HendrikK/healthmesh/tree/main/servers/partd-formulary-network-mcp#readme",
  "contact": "hendrik.kleine@gmail.com",
  "data_source": {
    "name": "CMS Quarterly Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information (SPUF)",
    "url": "https://data.cms.gov/provider-summary-by-type-of-service/medicare-part-d-prescribers/quarterly-prescription-drug-plan-formulary-pharmacy-network-and-pricing-information",
    "license": "U.S. Government work (CMS public use file); free to use. Drug names: NLM RxNorm via RxNav (public).",
    "refresh": "Quarterly CMS release; GitHub Actions monthly check of data.cms.gov for a new SPUF quarter"
  },
  "tools": [
    {
      "name": "partd_get_formulary_coverage",
      "title": "Is a drug covered on a Part D plan (tier, QL, PA, ST)?",
      "description": "Returns formulary coverage for a drug on one Part D plan: tier, quantity limit (amount per days), prior authorization and step therapy flags, from the CMS SPUF basic formulary file. Give rxcui, ndc or drug_name (name may match several strengths: up to 25 are returned). Also reports supplemental coverage of Part D-excluded drugs and indication-limited coverage. SPUF lags the live plan formulary by up to a quarter."
    },
    {
      "name": "partd_compare_um_across_plans",
      "title": "Compare a drug's tier and PA/ST/QL across Part D plans",
      "description": "For one drug (rxcui, ndc, or a drug_name resolving to a single RxCUI), counts Part D plans in a state (or nationally) that cover it and the share with prior authorization, step therapy and quantity limits, with the tier distribution, and lists plans. Filter by plan_type (pdp | mapd) and SNP inclusion. Plan-weighted (each plan-segment counts once), not enrollment-weighted."
    },
    {
      "name": "partd_get_formulary_trend",
      "title": "Year-over-year Part D formulary coverage and UM for a drug",
      "description": "Returns, per contract year 2023-2026 (same Q3 SPUF snapshot each year), the share of all Part D formularies covering a drug (RxCUI) and, among covering formularies, the share with prior authorization, step therapy and quantity limits, plus the median tier. Formulary-weighted (each formulary once), not plan- or enrollment-weighted. RxCUIs can change between years when RxNorm remaps a product."
    },
    {
      "name": "partd_get_plan_drug_pricing",
      "title": "Plan average unit cost for a drug (SPUF pricing file)",
      "description": "Returns the plan's average unit cost (total drug cost per unit, before beneficiary cost sharing) for an NDC (or rxcui/drug_name, mapped to SPUF's representative NDC) for 30/60/90-day supplies from the SPUF pricing file, plus the distribution of that unit cost across all plans pricing the NDC. Not a beneficiary out-of-pocket calculator. Dispensing fees are in the pharmacy networks file, which is not loaded."
    },
    {
      "name": "partd_search_drugs",
      "title": "Find RxCUIs for a drug name on Part D formularies",
      "description": "Searches RxNorm names of the drugs listed on Part D formularies (2023-2026 SPUF) and returns RxCUI, name, representative NDC and how many current formularies list each. Use to pick an rxcui for the other tools."
    },
    {
      "name": "partd_describe_dataset",
      "title": "What this Part D SPUF server covers",
      "description": "Describes the loaded SPUF release, counts (plans, formularies, drugs), field meanings, years available for trends, and what is not served (pharmacy networks, dispensing fees, beneficiary cost-sharing calculator)."
    }
  ]
}