CMS Delays Medicare Part D Enforcement Date Until February 2019

Molly PereiraFeatured News

The Centers for Medicare and Medicaid Services (CMS) has delayed enforcement of the Medicare Part D prescriber enrollment requirement. Providers now need to enroll by Jan. 1, 2019, instead of by Feb. 1, 2017.

Summary and Background

CMS published a final rule in May 2014 and an interim final rule in May 2015 addressing prescriber enrollment requirements in Medicare. Prescribers must be enrolled in an active status or validly opted out, except in very limited circumstances, for their written prescriptions to be covered under Part D. CMS previously announced that enforcement of the prescriber enrollment requirement would begin Feb. 1, 2017. While CMS is committed to the implementation of the prescriber enrollment requirements, CMS also recognizes the need to minimize the effect on the beneficiary population and ensure beneficiaries have access to the care they need.

To strike this balance, CMS will implement a multifaceted, phased approach that will align full enforcement of the Part D prescriber enrollment requirements with other ongoing CMS initiatives. Full enforcement of the Part D prescriber enrollment requirement will begin Jan. 1, 2019.

The CDA previously published an article outlining options for this requirement.