Physician Practice

Part D enrollment requirement delayed

Physician Practice Insider, March 22, 2016

CMS pushed back the deadline for physicians to enroll to prescribe Medicare Part D drugs. Physicians now have until February 1, 2017, to enroll. The previous deadline for the Part D Prescriber Enrollment Requirement was June 1, 2016. In a letter to Part D sponsors released March 1, CMS said the decision to delay the mandatory enrollment deadline was made to minimize disruptions to patient access to medications.

CMS stressed that although it has a duty to enforce the requirement as soon as possible, the delay will allow eligible professionals (EP) to complete their enrollment or file a valid opt-out affidavit. Providers who prescribe drugs but are not eligible to enroll in Medicare, such as pharmacists, are exempt from this requirement. EPs are urged to enroll or opt-out by August 1 to allow sufficient time for MACs to process applications and affidavits. The requirement was originally finalized in May 2014.

The Part D Prescriber Enrollment Requirement mandates that EPs, including physicians, dentists, and other eligible health professionals, enroll in Medicare. After February 1, 2017, Part D will not cover drugs prescribed by EPs who are not enrolled in Medicare or have not opted out. The Part D Enrollment Requirement is intended to help CMS counter fraud and abuse.

The final rule, FAQs, technical guidance, and the delay notification letter, are available on CMS’ website.

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