March 14, 2016
Medicare Part D Prescriber Enrollment Requirements Delayed: Prescribers Must Enroll by August 1
Medicare Part D prescribers, submit your enrollment application by August 1 to ensure your patients’ drugs are covered.
CMS has indicated that any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Medicare Part D may no longer cover drugs that are prescribed by physicians or other eligible professionals who are neither validly enrolled, nor opted out of Medicare.
The Centers for Medicare & Medicaid Services (CMS) has announced a delay in enforcement of the Medicare Part D prescriber enrollment requirement and released the following notice:
CMS is delaying enforcement of the Part D Prescriber Enrollment Requirements until February 1, 2017. We have a responsibility to enforce this crucial program integrity and basic quality assurance protection for Medicare Part D beneficiaries as soon as possible. However, we also have a responsibility to enforce it in a way that minimizes the potential for disrupting beneficiaries’ access to needed Part D medications.
With the revised date, prescribers will have sufficient time to complete their enrollment activities. In addition, this delay will provide Part D sponsors and pharmacy benefit managers (PBMs) and Medicare Advantage Organizations (MAOs) offering MA-PDs additional time to finalize the system enhancements needed to comply with the Part D Prescriber Enrollment Requirement and various guidance documents released by CMS.
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.
More information on enrollment for prescribers
CMS Guidance documents
ASA Washington Alert on Part D Prescriber Enrollment