Requirements for Prescribers of Medicare Part D Drugs Postponed Until December 2015
Dec 24, 2014
The Centers for Medicare & Medicaid Services (CMS) finalized its new regulation regarding Medicare Part D Prescription Drug Benefit Program (42 CFR § 423.120(c)(6)) on May 23, 2014. This rule requires physicians and other eligible professionals who write prescriptions for Part D drugs to (1) be enrolled in Medicare in an approved status, or (2) have a valid opt-out affidavit on file for their prescriptions to be covered under Part D. The final regulation stated that the effective date for this requirement would be June 1, 2015. CMS will delay enforcement of the rule until December 1, 2015.
Providers must submit a Medicare enrollment application or opt-out affidavit on or before June 1, 2015 to ensure sufficient processing times and avoid theor patients’ prescription drug claims from being denied by their Part D plans beginning December 1, 2015.
For more information on the Part D enrollment requirements, and how to enroll via the web, refer to MLN Matters® Article SE1434, “Provider Enrollment Requirements for Writing Prescriptions for Medicare Part D Drugs.”
AAPS information on Opting Out of Medicare is available at: http://www.aapsonline.org/index.php/article/opt_out_medicare/
Synopsis courtesy of Marilyn Singleton, MD, JD @MSingletonMDJD
