Part B Insider (Multispecialty) Coding Alert
Medicare Will Start Drug Coverage Within A Year
PDF
The final edition of Medicare's rule for the 2005 prescription drug benefit went on display in the Federal Register Jan. 21., stating Medicare drug coverage is less than a year away.
The rule includes a process for plan sponsors to negotiate with the Centers for Medicare and Medicaid Services on their program bids. It also provides a streamlined appeals process for beneficiaries who need to get drugs that aren't on their plan's formulary and "any willing pharmacy" standards for long-term care pharmacies.
The rule spells out that beneficiaries with both Medicare and Medicaid will automatically gain membership in a drug plan by September or early October. The law allows for "facilitated enrollment" of low-income beneficiaries. CMS will start "intensive outreach" to find these beneficiaries and, where possible, fill out enrollment applications for them. The rule also includes:
Part B Insider (Multispecialty) Coding Alert
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