On July 28, 2008, CMS published a final rule barring MA organizations from making midyear changes to non-prescription drug benefits, premiums, and cost-sharing submitted in their approved bids for a given contract year. The rule also clarifies that MA organizations offering certain kinds of plans restricted to employer and union group health plan sponsors may continue to offer benefit enhancements through means other than midyear benefit enhancements. The rule does not apply to programs of all-inclusive care for elderly. The rule is effective August 27, 2008.