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Issue 2006-04, April 2006
MLN Matters. . .Information for Medicare Providers
(Issued by the Centers for Medicare & Medicaid Services)
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Instructions for Provider Notification Regarding Streamlined Drug Coverage Materials for Health Care Professionals, a New Fact Sheet and Script for Recent Audio Conference
Provider Types Affected
Providers, physicians, and suppliers and their staff who prescribe medications for Medicare patients
Key Points
The Centers for Medicare & Medicaid Services (CMS) has developed three new products as part of the Medicare Prescription Drug Coverage (Part D) campaign for health care professionals:
Consolidated List of Links
A consolidated list of links to resources for prescribers is located at http://www.cms.hhs.gov/center/provider.asp  on the CMS Web site.
At this Web page, offices can get access to direct telephone numbers to a Medicare drug plan’s coverage determination staff, as well as to obtain model forms that will help speed this process.
Educational information for Fee-for-Service (FFS) providers is always available through our Medicare Learning Network drug coverage page at http://www.cms.hhs.gov/MedlearnProducts/23_DrugCoverage.asp on the CMS Web site.
Transition Policy Fact Sheet
A new fact sheet regarding the new transition policy, as well as the exceptions and appeals process for Medicare Prescription Drug Coverage, is available for use in prescriber offices. This resource fact sheet provides ready links to tools that will streamline the prescribing process under the new coverage.
CMS continues to work with groups representing physicians, pharmacists, patients, and Part D plans to simplify and standardize the information that physicians need to provide to plans.
The fact sheet is at http://www.cms.hhs.gov/MedlearnProducts/downloads/Part_D_Resource_Factsheet.pdf  on the CMS Web site.
An Important Message for Providers Regarding Medicare Part D from CMS Administrator Dr. Mark McClellan
Dr. McClellan’s message to providers describes the steps CMS is taking to implement the new Medicare prescription drug coverage. Dr. McClellan also discusses helpful resources for providers. Streaming video of this message is available at http://media.cms.hhs.gov/cms/McClellanPartDProvider.wmv on the CMS Web site.
Phone Conference Training Session
A PowerPoint presentation and audio replay of a recent phone conference training session is available, entitled “Working with Plan Formularies: Transition Supplies, Prior Authorization, Quantity Limits, Step Therapy, and Exceptions.”
This training session is geared towards guiding office staff through the exceptions process. These materials are located at http://media.cms.hhs.gov/cms/partner03022006.wma on the CMS Web site.
Other Special Edition Articles
Other special edition articles regarding the prescription drug program include, but are not limited to, the following:
SE0618 “2006 Standard Medicare Prescription Drug Coverage: Understanding Costs to Beneficiaries,” available at http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0618.pdf on the CMS Web site.
SE0603 “Medicare Prescription Drug Coverage: Essential Information and Resources for Prescribing Health Care Professionals – The Eleventh in the Medlearn Matters Series on the New Prescription Drug Plans,” available at http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0603.pdf on the CMS Web site.
SE0557 “Clarification on Part D and Fee-for-Service (FFS) Providers,” available at http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0557.pdf on the CMS Web site.
SE0502 “The Facts for Providers Regarding the Medicare Prescription Drug Program,” available at http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0502.pdf on the CMS Web site.
Disclaimer
This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents.
Medlearn Matters Number: SE0619
Related Change Request (CR) #: N/A
Effective Date: March 3, 2006
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