RCPA - Rehabilitation and Community Providers Association


Information about the Medicare Modernization Act #2
July 6, 2005

This is the second in a series of Infos on basic information for providers about the Medicare Prescription Drug Benefit. The first Info distributed June 24 provided a simple overview of highlights of the Medicare Modernization Act (MMA) and the Medicare Prescription Drug Benefit. More detailed information can be found on the Centers for Medicare and Medicaid Services (CMS) web site (www.cms.hhs.gov/medicarereform/pdbma/provider.asp).

A series of Medlearn Matters articles is available through a link to “Key Information for Providers” (www.cms.hhs.gov/medlearn/drugcoverage.asp) on the web site. A synopsis follows of SE0520, Information for Providers, Physicians, Pharmacists and Their Staffs About Medicare Prescription Drug Coverage; SE0537, The Fourth in the Medlearn Matters Series of Articles on the Medicare Prescription Drug Coverage; and SE0541, More Web-based Educational Products Available on Medicare Prescription Drug Coverage – The Fifth in the Medlearn Matters Series. For more information, please refer to the complete Medlearn Matters articles.

These articles provide sources for more information about the prescription drug benefit. They remind providers of the effective date (January 1, 2006), and encourage Medicare beneficiaries to choose a prescription drug plan when they have the opportunity. Otherwise, they will be subject to a financial penalty if they are not enrolled in a plan at the outset and choose to be enrolled at a later date. In May and June CMS sent notices to persons who would automatically qualify for the Low Income Subsidy (LIS), such as dual eligibles. The Social Security Administration is distributing notices and application forms to those who do not automatically qualify for the LIS, but may be eligible. CMS will include detailed information for beneficiaries in the 2006 Medicare and You Handbook, which should be distributed in October.

Providers may want to display posters -printable from www.cms.hhs.gov/medlearn/drugcoverage.asp, but currently out of stock for order until late July or early August. A detailed outreach toolkit can be downloaded and printed (www.cms.hhs.gov/partnerships/tools/materials/medicaretraining/pdctoolkit/download.asp) or ordered online (www.pcxhost.com/store/st1/tp1/products/product_detail.jsp?id=17457&unique=1120667548937&
for those providers who want to be more active in assisting Medicare beneficiaries with prescription drug benefit information.

Several fact sheets for beneficiaries are available from the provider information page (www.cms.hhs.gov/medlearn/drugcoverage.asp) and others from www.medicare.gov (select Search Tools, then Publications, then Go after All Publications and choose those related to Medicare Prescription Drug Benefits). Also, Medicare beneficiaries can obtain information from 1-800-MEDICARE. A new online tool, Learn About Your Medicare Prescription Drug Coverage Options, is available on www.medicare.gov to provide information and help with decision-making for Medicare beneficiaries.

Look for more information about the Medicare Modernization Act in upcoming Infos.

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