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Important message for providers who prescribe drugs for Medicare patients

March 31, 2016

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Recently, the Centers for Medicare & Medicaid Services (CMS) announced that beginning June 1, 2016, Medicare Part D prescription drug benefit plans may not cover drugs prescribed by providers who are not enrolled in (or validly opted out of) Medicare, except in very limited circumstances. However, to allow prescribers to have sufficient time to complete their enrollment activities, CMS has delayed the enforcement of the Part D Prescriber Enrollment Requirements until February 1, 2017.

CMS also strongly encourages prescribers of Part D drugs (except those who meet the definition of "other authorized prescribers") to submit their Medicare enrollment applications or opt-out affidavits to their Medicare Administrative Contractors (MACs) before August 1, 2016. This should provide the MACs with sufficient time to process the prescribers' applications or opt out affidavits and thus prevent prescription drug claims associated with their prescriptions from being rejected by Part D plans beginning February 1, 2017.

For more information, visit CMS's website.

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