tci Medicare Compliance & Reimbursement - 2006 Issue 6

DUAL ELIGIBLES: Health Plans, CMS Agree To Reimburse States; Stopgap Drug Coverage for Dual Eligibles

Senate keeps reimbursement legislation on 'simmer.'At least 26 states have stepped up to the plate to provide emergency stopgap prescription drug coverage to dual eligibles facing Part D enrollment problems, with no clear decision whether Medicare would reimburse their efforts--until now.Health plans, with support from the Centers for Medicare & Medicaid Services agreed Jan. 24 on ways they will work together to reimburse states for emergency coverage. Health plans will reimburse states for incorrect beneficiary copayment billing based on benes' plan contracts. CMS stated Jan. 17 that it would not reimburse states for filling benes' prescriptions. But...

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