tci Medicare Compliance & Reimbursement - 2006 Issue 7

PART D: Plan Formularies Fail To Provide Dual Eligibles With Access To Critical Meds

Enrollees must jump through contingency hoops to obtain non-formulary drugs.Prescription drugs that dual eligibles could once access easily through Medicaid are now hard to find together on the same Medicare drug plan. Only 18 percent of enrollees' Part D plans cover all of the drugs the dual eligible population used most in 2005, according to a report the HHS Office of Inspector General released Jan. 25.The report identifies the top 200 prescription drugs that the dual eligible population used in 2005. Statutory exclusions omit 22 of those drugs from Part D plans, and less than one in...

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