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As previously communicated, the Centers for Medicare & Medicaid
Services (CMS) has delayed the enforcement of the Part D Prescriber Enrollment
Requirements until February 1, 2017, to allow prescribers sufficient
time to complete their enrollment activities. Once in effect, CMS Medicare Part
D prescription drug benefit plans may not cover drugs prescribed by
providers not enrolled in (or validly opted out of) Medicare, except in very
limited circumstances.
CMS strongly encourages prescribers of Part D drugs (except those who meet
the definition of "other authorized prescribers") to submit their Medicare
enrollment applications or opt-out affidavits to their Medicare Administrative
Contractor (MAC) before August 1, 2016. This should provide MACs with
sufficient time to process the prescribers' applications or opt-out affidavits
and thus prevent prescription drug claims associated with their prescriptions
from being rejected by Part D plans beginning February 1, 2017.
For more information, please visit CMS's website.
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