Medicare Part D & Safety Net Providers

The Medicare Modernization Act of 2003 included many new provisions, including the Medicare Prescription Drug Coverage that began on January 1, 2006. While the Centers for Medicare and Medicaid Services (CMS) is the primary source of information on Medicare Part D, HRSA provides information of particular interest to our grantees and other safety-net providers. Frequently Asked Questions

• No Medicare Part D Late Enrollment Penalty for Low-Income Enrollees, CMS Says (CMS, 01-09-2007)
• Special Enrollment Periods 2007 (CMS, 01-04-2007)

• What Safety Net Providers Need to Know and Do
• Contracting with Medicare Prescription Drug Plans
• Model Safety Net Pharmacy Addendum to Pharmacy Contract

• Point-of-Sale Facilitated Enrollment for 2007 (CMS, December 2006)
• Point-of-Sale Facilitated Enrollment Process: Four Steps for Pharmacists (CMS, December 2006)
• Quick Answers to Frequently Asked Questions on Processing Claims for Dual Eligible Beneficiaries (CMS)

• Changes in Enrollment & Eligibility for Low Income Subsidy (December 2006)
• State Health Insurance Assistance Program State Offices and Other Resources to Help Medicare Beneficiaries Find Answers to Prescription Drug Coverage Questions (December 2006)

• Health Plans General Information (CMS)
• Medicare Managed Care Manual (CMS) basic information on Medicare Advantage and managed care plan types.
• Medicare Advantage Payment Guide for Out of Network Payments (CMS) payment language on Private Fee-For-Service plans, which pay providers at a rate determined by the Plan, at a minimum equivalent to what the provider would receive under original Medicare and do not restrict enrollees' choice of provider so long as the provider agrees to accept the  Plan's terms and conditions of payment.

• About Medicare Part D and the CARE Act