Physicians who prescribe medications to Medicare patients with Part D plans are getting more time to comply with new rules requiring that they either enroll in Medicare or have a valid record of opting out.
The deadline is now Jan. 1 to either enroll or opt out, although the Centers for Medicare & Medicaid Services (CMS) doesn’t plan to begin enforcing the new rules until June 1, 2016. This is the second time CMS has extended the deadline.
For those choosing to opt out, a word of caution: the opt-out period is for two full years and there is not an option for early termination. CMS has a very useful tool to help you make this decision and to know what form to fill out.
If you are not sure if you are enrolled or have opted out, CMS has published a public file to check. You can use the “Find in this Dataset” box in the upper right-hand corner to search by your National Provider Identifier or your last and then first name. The list will also tell you if you are in an opt-out status. If you are not on the list, you can apply through the Provider Enrollment, Chain, and Ownership System (PECOS). For information on how, there is a comprehensive step-by-step manual.
For more information on Part D, you can go to the Part D Prescriber Enrollment home page, which includes all of the above links as well as how to contact your local Medicare Administrative Contractor (MAC) for additional assistance.
– Barbara Hays, CPC, CPMA, is a Coding and Compliance Strategist for the American Academy of Family Physicians
Sign up to receive FPM's free, weekly e-newsletter, "Quick Tips & Insights," featuring practical, peer-reviewed advice for improving practice, enhancing the patient experience, and developing a rewarding career.