CMS to speed up E1 approvals

April 2, 2007

CMS is planning to implement systems changes that will help speed up responses to E1 eligibility queries.

CMS is planning to implement systems changes that will help speed up responses to E1 eligibility queries. Under the new rules, CMS will require prescription drug plan (PDP) sponsors to submit more data along with every enrollment transaction they submit to CMS. This change will mean that more data will be available to support E1 eligibility queries from pharmacies within 24 to 48 hours of the PDP's submission of the enrollment transaction. Under the new procedures, CMS will not accept enrollments without these data. According to CMS, these systems and process improvements will enhance the ability of pharmacies to assist beneficiaries who enroll late in enrollment periods, especially those whose enrollment becomes effective on Jan. 1, 2008.

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