I received a call yesterday from Chris Worral and Jeff Kelman of CMS, one relating news that affects the provision of Part D prescription drugs to more than 123,000 Medicare beneficiaries. Pharmacists, as front-line practitioners, will be instrumental in helping patients understand the situation and what is happening to their medicines.
CMS terminated its contract with a prescription drug plan (PDP), Fox Insurance Company, which was providing Part D benefits to patients in 21 states. The action took effect immediately. All patients enrolled with Fox will temporarily receive their medications through LI Net/Humana, a program run by Medicare and administered by Humana. More details about this action are available in a news article posted last night on pharmacist.com.
Dr. Kelman stressed to me that all drugs will be reimbursed and that patients should not walk out of pharmacies empty handed. Implicit in that statement is that CMS will back the pharmacies if questions arose.
I encourage all pharmacists who encounter patients affected by this action to take a moment to explain to them that medicines are being covered and that patients have the option of choosing a new PDP between now and May 1. If beneficiaries do not choose a new PDP, one will be assigned for them by CMS, so it is important they proactively choose a plan that will best meet their needs.