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CMS to protect residents against formulary changes

LTC Liability Monitor, May 4, 2006

CMS last week issued new guidance that protects nursing home residents against the sudden loss of coverage for medications they are taking under the Medicare Part D prescription drug program. CMS is requiring the prescription drug plans (PDPs) to submit all proposed mid-year formulary change requests to CMS for review and approval-except for expansions to the formulary or list of covered drugs.

The guidance addresses one of the chief criticisms of the Part D benefit: that it was unfair that PDPs could change their formularies while beneficiaries were locked into a drug plan for a full year. To see the guidance, go to http://www.hcpro.com/content/57566.cfm.

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