tci Medicare Compliance & Reimbursement - 2005 Issue 27

MEDICARE DRUG BENEFIT: CMS Demanding Extensive Formularies From PDPs

Some sponsors say government going back on its word.Could the Part D drug benefit wind up being a lot less profitable than many prospective sponsors hope?New guidance released by the Centers for Medicare and Medicaid Services echoes what the agency has been telling many sponsors in one-on-one meetings about the sponsors' formulary designs, and the news is troubling to some health plans and pharmacy benefit managers. In a new Frequently Asked Questions document available on its Web site, CMS reiterates that sponsors of prescription drug plans will need to include in their formularies "all or substantially all"...

To read the full article, sign in and subscribe to tci Medicare Compliance & Reimbursement.


Keep pace with evolving Medicare regulations — and onboard your team — with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI's Medicare Compliance & Reimbursement Alert will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, payer policies, the fee schedule, OIG target areas, and more.

  • Current newsletters added each month
  • Fully searchable archives - over 4200 articles
  • ALL years/issues back to 2003 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles
Access to this feature is available in the following products:
  • tci Medicare Compliance & Reimbursement +Archives

demo
request yours today
 subscribe
start today
 newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.