CMS leader cautions drug plans to smooth Part D transitions

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New Medicare drug benefit enrollees must still be offered a 30-day transition period and newly institutionalized beneficiaries must be given a 90-day transition period, the leader of the Medicare program reminded drug plans Friday.

Dr. Mark McClellan also took the opportunity to say his agency would hold the private plans fully accountable for handling appeals and exceptions cases as dictated by contractual requirements. The new Medicare Part D drug benefit began Jan. 1 with various glitches, which some expected to be repeated after Saturday, when a mandatory transition period expired.

Some plans were expecting to phase in their formularies gradually, several days at a time, according to reports.

In anticipation of more formulary exception requests, the Centers for Medicare & Medicaid Services said the drug plans could increase their staffing or take other pro-active steps to avert problems. CMS issued a fact sheet that can be seen at www.cms.hhs.gov/apps/media/press/release.asp?Counter=1817.

McClellan said CMS is studying how, and how quickly, drug plans handle complaints. Also, his agency will release the number of enrollees in each plan and the average customer-wait times for service. He expected "most" of that information to be available by May 15.