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Any physician or other eligible professional who prescribes Part D drugs
must either enroll in the Medicare program or validly opt out in order to
prescribe drugs to their patients with a Part D prescription drug benefit plan.
The Centers for Medicare & Medicaid Services (CMS) announced that Medicare Part
D will no longer cover drugs that are prescribed by physicians or other
eligible professionals who are neither validly enrolled, nor opted-out of
Medicare. CMS previously announced that enforcement of the prescriber
enrollment requirement would begin on February 1, 2017. While CMS is committed
to the implementation of the prescriber enrollment requirements, they also
recognize the need to minimize the impact on the beneficiary population and
ensure beneficiaries have access to the care they need.
To strike this balance, CMS will implement a multifaceted, phased approach
that will align full enforcement of the Part D prescriber enrollment
requirements with other ongoing CMS initiatives. Full enforcement of the Part D
prescriber enrollment requirement will begin on January 1, 2019.
Therefore, all prescribers must be enrolled in the Medicare program
by January 1, 2019, to ensure enrollees get their prescriptions.
In the interim, CMS will begin phasing in targeted enforcement of the
regulation with additional safeguards to increase prescriber enrollment,
identify and eliminate vulnerabilities, and strengthen the Medicare Part D
program.
For more information on this requirement, visit the CMS website.
]