In 2018 the Centers for Medicare and Medicaid Services (CMS) suddenly removed Auryxia (ferric citrate) from the Medicare Part D drug formulary and began to require prior authorization for the few indications it would reimburse. CMS gave little information about the reversal but apparently made the decision because it views ferric citrate at a mineral product, like dietary supplements such as Vitamin C. Dietary supplements are not covered by Medicare except in a few cases.