tci Medicare Compliance & Reimbursement - 2007 Issue 21

COMPLIANCE: Protect Patients By Noting These Part D Requirements

Formulary clarifications warrant close watch.The feds' final call letter notes two other formulary-related changes that could affect patients' ability to receive the drugs they need:1. Six classes of clinical concern. In 2008, formularies must include all or substantially all drugs in these six classes that were available on April 16, 2007--the deadline by which prescription drug plans (PDPs) had to submit their formularies to the Centers for Medicare & Medicaid Services (CMS). New for 2008: New drugs or newly approved uses for established drugs within the six classes that come on the market after the above date will...

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