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Medicare Part D: Plan Sponsorsí Processing and CMS Monitoring of Drug Coverage Requests Could be Improved
Under the Medicare Part D program, prescription dr

Our Price: $20.00
By Kathleen M. King (au)
Year: 2008
Pages: 42
Binding Paperback

Product Code: 143790100X

Under the Medicare Part D program, prescription drug coverage is provided through plans sponsored by private companies. Beneficiaries, their appointed representatives, or physicians can ask sponsors to cover prescriptions restricted under their plan -- a process known as a coverage determination -- and can appeal denials to the sponsor and the independent review entity. This report reviews: (1) the processes for sponsorsí coverage determination decisions and the approval rates; (2) the processes for appealing coverage denials and the approval rates at the sponsor and IRE levels; and (3) the Centers for Medicare and Medicaid Servicesí efforts to inform the public about sponsorsí performance and oversee sponsorsí processes. Charts.

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