Part D Drugs to Remain

Covered When Prescribed 

by Pharmacist Providers

Tomorrow, the U.S. Department of Health and Human Services will issue an important interim final rule allowing pharmacist-prescribed Part D medications to continue to be reimbursed by Medicare. Under the rule pharmacy claims for reimbursement for Medicare Part D prescriptions written by prescribers other than physicians (pharmacists), who are permitted by state law to prescribe medications, will not be rejected at the point of sale or denied by the plan if all other requirements are met. In California, pharmacists working as prescribing providers under collaborative drug therapy agreements are included in this rule.

This clarifying regulation was necessary because of certain provisions contained in the Affordable Care Act wherein pharmacists were not originally classified as 'eligible professionals' to prescribe medication in the Medicare program. Therefore, any pharmacist prescription under collaborative drug management agreements would not have been eligible for reimbursement unless this corrective action was implemented.

This interim final rule is effective June 1, 2015.

To read the entire interim final rule, click here.