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Reminder: Important message for providers who prescribe drugs for Medicare patients

June 30, 2016

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As previously communicated, the Centers for Medicare & Medicaid Services (CMS) has delayed the enforcement of the Part D Prescriber Enrollment Requirements until February 1, 2017, to allow prescribers sufficient time to complete their enrollment activities. Once in effect, CMS Medicare Part D prescription drug benefit plans may not cover drugs prescribed by providers not enrolled in (or validly opted out of) Medicare, except in very limited circumstances.

CMS 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 Contractor (MAC) before August 1, 2016. This should provide 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, please visit CMS's website.

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