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Do you know the new Medicare prescription enrollment rules?

May 26, 2015

Do you know the new Medicare prescription enrollment rules?

This is a memorandum from Medicare that may be of interest to you. Note: Enrollment applications or opt-out affidavits are due by June 1, 2015.

The Centers for Medicare and Medicaid Services (CMS) has finalized a rule requiring physicians and other professionals who write prescriptions for Part D drugs to either: Be enrolled in Medicare in an approved status.

Have a valid opt-out affidavit on file for their prescriptions to be covered under Part D. Although the final rule states that the effective date is June 1, CMS will delay enforcement of this rule until Dec. 1, 2015. However, prescribers of Part D drugs should either submit their Medicare enrollment applications or opt-out affidavits to their Medicare Administrative Contractors (MACs) by June 1. This will ensure that there is sufficient time to process the applications before the Dec. 1 deadline.

In order to prepare prescribers and Part D sponsors for the deadline, CMS is releasing an enrollment file online that identifies physicians and eligible professionals who are enrolled in Medicare in an approved or opt-out status. This list is available and will be updated every two weeks through the Dec. 1 enforcement date.

View the official CMS announcement.

This information is provided by the United States Department of Health and Human Services.

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