Medicare Part D Eligible Ndc Codes
Medicare Part D Eligible Ndc Codes - News
FYI, in terms of dual eligible, the slide that be previously in our deck, if you remember, 9% by value of our payer mix is the Medicare Part D dual eligible. So that's as per the previous slides we have for Q1. As you know, there were significant price
Medicare Part D Coverage Gap Questions & Answers
LisaMcNair@CIS-Partners.com
Yesterday, Compliance Implementation Services (CIS) conducted a webinar addressing questions pharmaceutical manufacturers and other interested parties had regarding the new Medicare Part D Coverage Gap Program as we approach the release of the first round of invoices.
CIS solicited questions from the pharmaceutical industry and contacted CMS and the TPA, Palmetto GBA to obtain guidance on addressing and answering these questions.
There are numerous questions still outstanding, as these questions are answered and guidance is provided we will continually update our blog. We are working towards another webinar in the near future on this subject, inviting several special guests.
Below, please find the submitted questions and their responses. In reviewing these questions, if you have additional questions, please feel free to submit them to me at lisamcnair@cis-partners.com .
Q: The draft letter sent out regarding the Appeals Process, how is that different from the Dispute Process?
A: CMS is implementing the appeals process in accordance with Section 1860D-14A(c)(1)(A)(vii) of the Affordable Care Act of 2010 and Section V of the Medicare Coverage Gap Discount Program Agreement. CMS is required to provide a way for pharmaceutical manufacturers to resolve disputes.
Q: Do we need to provide any product or sales information for invoicing?
A: No, the products eligible for this program are based upon the information in the FDA database. It is the responsibility of all pharmaceutical manufacturers to ensure this information current and up-to-date. Guidance has been released on this subject. Please refer to the “Medicare Coverage Gap Discount Program – Manufacturer Program Guidance” located on the CMS website at:
Q: Please clarify that if an invoice is received and requires remediation by the TPA, the manufacturer would not be required to submit payment until a new invoice is submitted.
Medicare Part D Eligible Ndc Codes - Bookshelf
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