Medicare Updates its Medicare Advantage and Prescription Drug Plan

Medicare has formulated a response to the opioid epidemic by altering the authority and ability of Medicare Advantage Plans and Prescription Drug Plans to implement drug management programs.  This change in the regulations issued by Medicare is the product of the Comprehensive Addiction and Recovery Act of 2016 (CARA) which authorized Medicare prescription plans to establish drug management programs beginning 1/1/2019.  This means as early as 1/1/2019, an MAP or Medicare Prescription Drug Plan will have the ability to identify “at-risk beneficiaries” and implement drug management programs for those individuals.  This also means a prescription provider may reach out to a prescriber or beneficiary regarding such management programs.  It is important that prescribers and beneficiaries are educated that such programs may be used by their Medicare insurance provider in the future.

We will keep you posted as the war on opioids further develops.

Leave a Reply