Do pharmacies need to contract with Medicare Part D plans in order to be reimbursed for services to Medicare enrollees?
Yes. As of January 1, 2006, pharmacies will be able to receive reimbursement only for those Medicare patients (including dual eligibles, patients covered by both Medicaid and Medicare) enrolled in Prescription Drug Plans (PDPs) that the pharmacy has contracts with. Pharmacies will no longer be reimbursed by state Medicaid programs for prescriptions provided to dual eligible patients. For information about contracting with PDPs, please see the Health Resources and Services Administration’s Medicare Part D & Safety Net Providers: Contracting with Prescription Drug Plans.
Related Questions
- Can a healthcare provider be reimbursed for indirect services? Do Medicare, Medicaid, or private insurance pay for indirect services?
- Do pharmacies need to contract with Medicare Part D plans in order to be reimbursed for services to Medicare enrollees?
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