Updates to the Part D Prescription Drug Policy

Medicare Set-Aside Blog on July 24, 2006
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Once MSAs with prescription drug inclusions were being reviewed, updates to the Part D drug policy were made in the following CMS memo. Therefore, this memo supercedes the Dember 30, 2005, memo dealing with the original Part D policy change.

Some of the questions and answers discussed include:

Should submitters provide an explanation in the cover letter when the claimant has not been prescribed drugs for the work-related injury, illness/disease or if the drugs prescribed are excludable under the Medicare Modernization Act of 2003 (MMA)?

Where a WC claim settled prior to January 1, 2006, can the claimant use the WCMSA funds to pay for prescription drug expenses related to the WC injury?

Has CMS published any guidelines about how to price for future prescription drug expenses in WCMSAs?

Read the complete memo at CMS

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