Medicare Prescription Drug Coverage

This section provides Medicare prescription drug coverage information and how it may affect Medicaid members with Medicare. Check this section regularly for updates.

Information can also be found in archived Banner Pages, Bulletins and Newsletters. Use the search option find documents.

Member Notices

Document Number	Date	Topic
BT200531	12/21/2005	Medicare Prescription Drug Changes Due to the New Medicare Prescription Drug Coverage
BT200523	10/31/2005	Medicare Prescription Drug Coverage

Documents

Topic	Date Posted
Medicare Drug Coverage ABD Training Workbook	February, 2009
Medicare Coverage ABD Charts DeskAid	February, 2009
Point-of-Sale Facilitated Enrollment (POS FE) Process Four Steps for Pharmacists February 28, 2008	March, 2008
Convenient Access to LTC Pharmacies	June, 2007
Indiana Medicaid Coverage for Medicare Part D Excluded Drugs (January 2007) contains listing of excluded drugs by drug class and category with explanations.	January, 2007
Medicare Part D Tip Sheet for 2007 contains information about coverage and assistance.	December, 2006
Medicare Consumer Alert: Medicare Fights Against New Schemes To Defraud Beneficiaries. Medicare beneficiaries warned to be aware of telephone scams surrounding new Medicare Drug Benefit.	June, 2006
Home Infusion Coordination Decision Tree	March, 2006
Payment of Home Infusion Therapy for Medicare Beneficiaries	March, 2006
CMS Letter to SMD Regarding Roles of Medicaid vs. Medicare When Providing Home Infusion Therapy	March, 2006
CMS Letter Concerning Billing Clarification for Home Infusion Therapy	March, 2006
DHHS Tip Sheet: Using Medicare Prescription Drug Coverage Before Receiving A Drug Plan Membership Card	March, 2006
Secretary's One Month Progress Report on the Medicare Prescription Drug Benefit (02/01/2006): The report details the need for more progress for the Medicare Prescription Drug Program and extends transition coverage to 90 days.	February, 2006
Email from Gregory R. Dill of the CMS Chicago Regional Office informing Indiana Medicaid of Secretary Leavitt's extension of the transitional coverage period.	February, 2006
CMS abbreviated list of Part D Drugs and Part D Excluded Drugs derived from frequent inquiries (02/07/06).	February, 2006
CMS memorandum (02/07/06) to all Part D Plan sponsors regarding extension of the 30-Day Billing Limit for Pharmacists and Beneficiaries.	February, 2006
CMS letter (02/03/06) addressing issues regarding prescription Niacin products.	February, 2006
Comprehensive Listing of Drugs in the USP Model Guidelines for Drugs Approved Through October 2004 contains a listing of the Part D eligible drugs.	February, 2006
PerSe/NDCHealth letter (January 11, 2006) contains tips for pharmacists to help increase the match of Medicare Beneficiaries in the Eligibility (E1) Responses.	February, 2006
Point of Sale (POS)-Facilitated Enrollment contains questions and answers provided by WellPoint (02/01/2006)	February, 2006
Medicare Parts B and D Coverage Flashpoints is a reference guide to address the most common Parts B and D coverage determination scenarios.	February, 2006
Joint Recommendation from CMS and Alliance - Medicare Part D as it applies to the LTC setting.	February, 2006
Indiana PDP Appeals and Exceptions Contacts includes information from CMS, with E-mail links provided.	February, 2006
Request for Prescription Information or Change, Medicare Prescription Drug Coverage, Provider Communication Form is the faxable form CMS recommends providers use to expedite communication between the pharmacists and the prescribing physicians.	February, 2006
Letter to pharmacy and prescribing providers from CMS provides general information about the appeals and exception process related to Medicare Part D.	February, 2006
Letter from Anthem Prescription explaining the implementation of edit 07 - Invalid Cardholder ID, which is effective February 2, 2006.	February, 2006
CMS letter to All Part D Sponsors (January 6, 2006) for re-emphasizing the pharmacy transition policies.	January, 2006
CMS letter to Medicare Part D Plans (January 4, 2006) that contains information to assist pharmacists in completing pharmacy transactions.	January, 2006

Forms

The Part D Formulary Information for Physicians website contains information for physicians, including pharmacy technical support contacts, exceptions and appeals contacts, Medicare prescription drug coverage provider communication form, and Medicare prescription drug coverage determination request form.

In addition to using the web-based Prescription Plan Finder tool at www.medicare.gov for individual resident inquiries, nursing homes without Internet access or who need Medicare prescription drug plan enrollment information for multiple residents can now use the Long Term Care (LTC) Nursing Home Administrators FAX Procedures XXXXX. The form contains instructions and a fax cover sheet.