CMS Issues Final Ruling For Medicare Part D
May 21, 2014
Katie Sullivan, MA
A CMS ruling would force healthcare providers to enroll in Medicare by June 1, 2015, if they plan to prescribe medications that are paid for by the program. The agency said in a report that changes to Medicare Part D were necessary in order to cut down on inappropriate prescription practices and to improve patient safety.

“Our findings raise concerns about the appropriateness of Medicare payments and about patient safety,” said a report released by the Health and Human Services Office of Inspector General (OIG). “They also show the need for increased oversight of prescribers to ensure that Medicare does not pay for drugs ordered by individuals who do not have the authority to prescribe. Drugs prescribed by such individuals may not be appropriate and may endanger patients. Such practices may also contribute to the prescription drug abuse problem in our Nation.”

OIG made several recommendations to CMS in regard to the Medicaid Part D changes. These included:
  • Requiring sponsors to verify that prescribers have the authority to prescribe drugs.
  • Increasing the Medicare drug integrity contractor’s (MEDIC) monitoring of prescribers.
  • Ensuring that Medicare does not pay for prescriptions from individuals without prescribing authority.
  • Following up on individuals without prescribing authority who ordered prescriptions.
“Honest physicians and eligible professionals who engage in reasonable prescribing activities would not be impacted by our proposal,” stated CMS.

CMS officials also expect that the changes would save the federal government $1.6 billion over the next 10 years.
Around the Web

Docs Will Need To Enroll In Medicare If They Want To Prescribe Part D Drugs [Modern Healthcare]