Long-Term Care

Medicare Part D: SNFs, LTCPs, and dual-eligible residents

Billing Alert for Long-Term Care, January 1, 2009

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The transition to the Medicare Prescription Drug Program, known as Medicare Part D, was difficult for the long-term care industry, and providers still face billing problems when dealing with dual-eligible SNF residents.

Unlike individuals covered only by Medicare, SNF residents enrolled in both Medicare and Medicaid, known as dual-eligible residents, are exempt from the out-of-pocket expenses accompanying Part D. However, the program’s attempt to protect the vulnerable financial situations of dual-eligible residents has inadvertently shifted the responsibility for many of these expenses onto SNFs and long-term care pharmacies (LTCP).

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Billing Alert for Long-Term Care.

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