Archive
Weekly Email: Week of January 16
I. Conference Call Information (January 18, 2006; January 19, 2006; January 31, 2006)
II. In the News
Part D PDP Enrollment Reaches 3.6 Million
III. Helpful Information
CMS Issues New Part D Implementation Instructions
No Weekly E-Mail Next Week
IV. HAP Resources
HAP Documentation Form for Part D Implementation Issues
Helping Health Care Consumers in an Ever-Changing World: The HAP Conference Track
I. Conference Call Information
During HAP's second Medicare conference call this month, scheduled for Wednesday, January 18, at 3:00 p.m. EST, we will review and discuss the current status of Part D implementation glitches and how SHIPs can team up with pharmacies and states to help Medicare beneficiaries get their prescriptions filled. We will also spend time analyzing how SHIPs can team with physicians and pharmacies to help beneficiaries address Part D drug plan transition, utilization management and formulary exception issues. Background materials and tools will be posted prior to the call. Please join us!
If you have questions about the call, please contact Kelly Brantley at Kbrantley@healthassistancepartnership.org or Hilary Dalin at Hdalin@healthassistancepartnership.org.
The next Medicaid conference call is scheduled for Thursday, January 19, at 1:00 p.m. EST. Note that we have changed the topic of our call to "State actions to protect duals affected by Part D." A number of states have taken steps, by executive order or legislation, to pay for drugs for dually eligible persons who encounter Part D implementation-related problems at the pharmacy. We will exchange information about how these actions are working.
Some information about state actions is posted on Families USA's website. We will soon add links to state laws and executive orders to this site. Please also check the Health Assistance Partnership's home page on Thursday for any further background information for the call.
We hope to re-schedule the topic of “Medicaid and teen health” to next month’s call. We decided to make the change after hearing from many Medicaid consumer assistance programs that they are too inundated with Part D problems to talk about other issues right now. If you have questions about Thursday’s call, please contact Cheryl Fish-Parcham at Cparcham@healthassistancepartnership.org.
HAP and the National Long-Term Care Ombudsman Resource Center (NORC) facilitate a long-term care workgroup to discuss and strategize about the impact of Medicare Part D implementation on long-term care residents and their facilities. The workgroup, which consists of SHIPS, LTC Ombudsmen (LTCOPs), and Senior Medicare Patrol programs (SMPs), convenes bi-monthly for conference calls to discuss how the SHIP, LTCOP and SMP networks can best partner to enable long-term care residents to understand Medicare Part D and obtain needed prescriptions. The next conference call is scheduled for Tuesday, January 31 at 3:00 p.m. EST. All staff and volunteers from the three networks are welcome to join our meetings. Please contact Lee Thompson at lthompson@healthassitancepartnership.org if you would like to participate in the upcoming call, or if you have questions about the long-term care workgroup.
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II. In the News
Part D PDP Enrollment Reaches 3.6 Million
The federal Department of Health & Human Services (HHS) announced that more than 3.6 million people have signed up for stand-alone Part D Prescription Drug Plans (PDP). In a press release issued on Tuesday, January 17, the agency reported that more than 2.6 million Medicare beneficiaries enrolled in PDPs since December 13, 2005.
III. Helpful Information
CMS Issues New Part D Implementation Instructions
On Friday January 13, 2006, the Centers for Medicare & Medicaid Services (CMS) issued additional mandatory instructions to all Part D plans regarding low-income subsidies and transition first fills. In its latest directive to the Part D plans, CMS required plans to establish a telephone call center unit staffed by customer service representatives with the authority to authorize a pharmacy to fill prescriptions for low-income subsidy recipients at the appropriate co-pay level upon verification through the plan, the CMS pharmacy help desk, or the beneficiary of LIS eligibility, even in the absence of electronic verification through a pharmacy eligibility transaction query (called "E1"). Similarly, plans must have dedicated phone lines for pharmacists, staffed by personnel with the authority to override utilization management protocols, such as prior approval requirements, for transition first fills.
HAP has posted these new CMS directives, along with CMS’s January 6 and January 9, 2006 directives to the drug plans and many other resources, on its “First Aid Kit for Part D Implementation”.
To discuss the CMS directives or HAP’s Part D implementation resources, please contact Kelly Brantley at Kbrantley@healthassistancepartnership.org or Hilary Dalin at Hdalin@healthassistancepartnership.org.
No Weekly E-Mail Next Week
There will be no HAP Weekly E-Mail next week, due to our preparations for, and participation in, the HAP Conference. We’ll be back with the next edition of the Weekly E-Mail during the week of January 30.
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IV. HAP Resources
HAP Documentation Form for Part D Implementation Issues
The HAP Medicare Team invites you to use our on-line to help record any Part D implementation issues that you’ve seen arise. We are interested in capturing new, as well as chronic, issues. Please use the Documentation Form on HAP’s website. Thanks for all of your contributions!
Helping Health Care Consumers in an Ever-Changing World: The HAP Conference Track
The HAP conference begins next week on Wednesday, January 24. You can still register for it through the Families' Health Action 2006 web page . Below the picture of the Mayflower Hotel on the right-hand side, check "I'll be there." Then click "Register," and follow the instructions on the registration page. If you want to pay by check, look to the left of the "Register" box, and follow the link in "To register and pay by check, click here”. Conference registration is now $325. You may still be able to book a hotel room at the Renaissance Mayflower Hotel, although the hotel's room rate now depends upon availability. To make your room reservation, call the Renaissance Mayflower at 1-800-HOTELS1 or 202-347-3000, and mention that you're with the Health Action 2006 conference.
If you want to meet individually with any HAP staffers during the conference, there’s still time to make an appointment for technical assistance, as noted in the email about the conference sent on Friday, January 6. Remember, HAP defines "technical assistance" broadly: you may have questions about how Medicare Part D works with your state's pharmacy assistance program (SPAP), or you may wonder about the best data-collection methods for your program, or you may just want another pair of eyes to review your written materials. We're happy to help in any way we can!
If you plan to join HAP on Wednesday for the facilitated discussion of issues affecting consumer health assistance programs and/or for the dinner (hosted by HAP) for those who are interested in the HAP track, please complete BY FRIDAY, JANUARY 20 AT NOON this brief form. In addition, please send any issues that you would like to raise during the discussion to Christin Engelhardt at cle@healthassistancepartnership.org.
Finally, if you have any questions about the conference or about the agenda, please contact Christin Engelhardt at cle@healthassistancepartnership.org.
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