CMS updates COVID-19 guidance to Medicare Advantage and Part D plans

NCPA sent out the following articles in their Friday edition of qAM . Click here if you are interested in subscribing to this valuable resource offered by NCPA.

On April 21, CMS released a guidance document to Medicare Advantage organizations, Part D sponsors, and Medicare-Medicaid plans updating previously released information from March 10. The guidance includes several relevant provisions for community and long-term care pharmacies, including:

  • Coverage of testing and testing-related services for COVID-19
  • Relaxed enforcement of signature log and prior authorization requirements
  • Suspension of plan-coordinated pharmacy audits
  • Requirement for Part D sponsors to permit 90-day fills, refills, or transition fills
  • Relaxation of short-cycle fill requirements for LTC patients.

NCPA successfully advocated that CMS temporarily waive Part D medication delivery documentation and signature log requirements during the public health emergency and adopt a temporary policy suspending plan-coordinated pharmacy audits . NCPA also successfully advocated for community and LTC pharmacies regarding relaxing prior authorization, point-of-sale edits, and short-cycle dispensing requirements. For more information, see NCPA's member summary .

NCPA joined numerous national and state associations on a letter urging Congress to authorize additional funds for the Paycheck Protection Program that was adopted under the CARES Act. The Small Business Administration announced last week that the program has exhausted funds. The President is expected to sign the bill immediately so it's crucial you have your application ready to go once additional funding becomes available. Check out our update on the CARES Act and SBA funding.

On Monday, NCPA joined PCCA and other pharmacy groups in a letter to Vice President Mike Pence, HHS Secretary Alex Azar, CMS Administrator Seema Verma, and FDA Commissioner Hahn emphasizing the need for patient access to medications — both those provided by the pharmaceutical manufacturers and those provided by pharmacists through compounding — during the COVID-19 public health emergency that are now in short supply due to ongoing drug shortages. Our groups asked FDA, CMS, and HHS to review certain provisions that may be hindering pharmacists' ability to compound medically necessary drugs during the COVID-19 public health emergency. NCPA will continue to advocate for compounding pharmacies to enhance their participation in addressing the COVID-19 crisis
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