From: Worrall, Chris M. (CMS/OA)
Sent: Thu 12/20/2007 5:10 PM
To: PHARMACY_MMA-L@LIST.NIH.GOV
Subject: Medicare Information for Pharmacists

Final Preparations for 2008 are Underway…

CMS, plans, pharmacies and beneficiaries have now entered the final stretch to prepare for the new plan year.  We made our Readiness Checklist and we’re checking it twice to make sure plans are prepared and systems are updated with timely and accurate 2008 enrollment information; and we have set up a Part D operations monitoring program to make sure we’re aware of any emergency issues program issues that may unexpectedly occur on January 1, 2008.

As we all know, January is the busiest month in the pharmacy due to the millions of changes Americans make to their insurance coverage.  Now is the time for pharmacists to familiarize themselves with Part D changes for 2008.  In the last several weeks, we have released updates on the updated vaccine <http://www.cms.hhs.gov/ContractorLearningResources/downloads/JA0727.pdf>  administration billing process for 2008, the Point-of-Sale <http://www.cms.hhs.gov/OpenDoorForums/Downloads/POSFEPharmacyTipSheet12707R.pdf>  Facilitated Enrollment process, our Best Available Evidence <http://www.cms.hhs.gov/pharmacy/downloads/update110107.pdf>  process, formulary transition <http://www.cms.hhs.gov/PrescriptionDrugCovContra/Downloads/PDBMChap6FormularyReqrmts_03.09.07.pdf>  policies (pages 24-32) and how to handle Medicare Part D complaints <http://www.cms.hhs.gov/partnerships/downloads/11259P.pdf>  (updated from the previously distributed link).  Additionally, CMS has created a new consumer tip sheet, in both English <http://www.medicare.gov/Publications/Pubs/pdf/11343.pdf>  and Spanish <http://www.medicare.gov/Publications/Pubs/pdf/11343_S.pdf> , for beneficiaries that may need a prescription filled before they have received their new plan ID card and have updated the Part D Reference Guide <http://www.cms.hhs.gov/Pharmacy/downloads/Pharmacy%20Reference%20Document4.pdf>  for Pharmacists; a comprehensive guide to CMS policies as they relate to Medicare Part D.

Continuing LIS Outreach Activities…

As a reminder – if you come across someone who may qualify for extra help, they can still apply and if they qualify, enroll in a prescription drug plan anytime throughout the year. CMS has developed an easy-to-understand brochure outlining the value and process to apply for the extra help. You can obtain copies of these publications and other resources for outreach to people who may qualify for extra help in our LIS Outreach Toolkit at http://www.cms.hhs.gov/limitedincomeandresources/ on the web.

Chris Worrall
Special Assistant