tci Medicare Compliance & Reimbursement - 2005 Issue 35
Long-Term Care: Choose Nursing Home Drug Providers Carefully
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Article Overview
This article discusses the operational impact of Medicare Part D on long-term care facilities and resident prescription drug coverage. It is aimed at nursing home administrators, long-term care providers, and billing or compliance staff who need to understand the transition from Medicaid drug coverage to Part D for residents who qualify for both programs. The piece covers enrollment timing, the roles of residents and representatives in plan selection, and the general consequences of default enrollment if no plan is chosen.
Why This Topic Matters
Facilities need to prepare for a shift in drug coverage that can affect residents’ access to medications and the administrative handling of plan selection. Understanding the timing and responsibilities involved helps reduce the risk of coverage gaps during the transition.
What You Will Learn
- How Medicare Part D affects long-term care residents
- Why dual-eligible residents require special planning
- What responsibilities facilities may have during the plan-selection process
- How default enrollment can occur when no plan is selected
Who Should Read This
- Long-term care administrators
- Nursing home staff
- Billing and reimbursement professionals
- Compliance staff
- Case managers
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