Mental Health Part D News Alert

January 16, 2006

Important Updates on Part D Implementation:
Bush Administration Requiring Action from Plans; CMS Releasing New Updates

With thousands of reports of patient problems in obtaining medications under Medicare Part D, the Bush administration responded to problems with Medicare Part D over the weekend by communicating directly with prescription drug plans (PDPs).  The plans were instructed that they must supply 30-day supplies of any drug a patient was taking before January 1, and that co-payments for dual eligibles cannot exceed $5.  

The Bush administration stepped in after about 20 states have already stated that they will pay for the prescription drugs of residents who should have received medications under Medicare.  Several of the states have also declared public health emergencies in their states, with thousands of individuals unable to obtain their medications.

Click here to read the full article:

CMS also released information to partners last week with updates on their actions to remedy the problems.  Specifically, CMS states that they are:

• Removing any glitches from their enrollment and billing systems as quickly as possible
• Working with states to provide prescriptions to beneficiaries and to ensure that states are “the payer of last resort”
• Requesting that all PDPs have expedited processes for cost sharing approvals as well as transition policies
• Establishing a network of caseworkers throughout the country to help with additional problems or concerns

Click here to read the full letter from CMS.

We are continuing to monitor Part D.  Please contact us at PartD@psych.org or call 866-882-6227 with feedback on specific situations.