What your practice can expect when Part D coverage begins

Why This Topic Matters

The piece helps readers understand why prescription drug coverage questions may increase as Medicare Part D begins and why practices may need to respond quickly to pharmacy inquiries. It also highlights the operational importance of having organized documentation available for drugs that may be covered under more than one Medicare benefit.

Article Sections

1. Coverage issues at the start of Medicare Part D

   Introduces the new Medicare prescription drug program and the general uncertainty surrounding coverage coordination. It discusses the broader implications for practices, pharmacies, and payers.

2. Prior authorization and pharmacy inquiries

   Describes expected changes in pharmacy requests, plan-specific forms, and the role of prior authorization. It also notes the operational burden created by multiple drug plans.

3. Practice preparation and recordkeeping

   Focuses on maintaining patient information, organizing diagnoses, and keeping drug plan resources accessible. The section emphasizes workflow readiness for staff who may receive coverage-related calls.

4. Coverage categories with Medicare Part B and Part D overlap

   Summarizes several broad drug categories that may be subject to either Medicare Part B or Part D coverage depending on the situation. The section presents a high-level comparison intended to show why coverage questions arise.

5. Source note and risk indicators

   Includes the source attribution for the coverage summary and a brief list of general risk indicators referenced in the article. It serves as supporting context for the coverage discussion.