Action Required: Medicare Part D Enrollment Requirement

The Centers for Medicare & Medicaid Services (CMS) finalized CMS-4159-F “Medicare Program; Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs” on May 23, 2014.

Per the mandate, if you are a provider who is not enrolled with Medicare and wish to be, you must enroll by June 1, 2015 to ensure that your Medicare Administrative Contractors (MACs) have sufficient time to process the applications before the January 1, 2016 enforcement date, to avoid your patients' prescription drug claims from being denied by their Part D plans. If you are already enrolled with Medicare, no action is required.

By enrolling with Medicare, providers will remain participating Medicare Advantage providers with Independent Health and will continue to be able to treat and prescribe Part D medications to their patients without interruption. If you take no action related to this enrollment request, although your medical claims will be paid, your Part D drugs will not be paid, which could adversely affect the treatment of your Medicare patients.

To ensure continuity of care for our members' care, Independent Health encourages all physicians and eligible health care providers who write prescriptions for Part D drugs to enroll with Medicare by June 1, 2015.

If you would like additional information on this mandate or how to enroll with Medicare, view a memo published by MLN Matters®.

If you have any questions, please contact our Provider Service department by calling (716) 631-3282 or 1-800-736-5771, Monday through Friday from 8 a.m. to 6 p.m.