GAO report criticizes Part D procedures

May 21, 2007

Not only have CMS' procedures created problems for dual-eligibles attempting to find a prescription drug plan, but the report notes that pharmacies may be affected adversely when "key information about a beneficiary's dual eligibility is not yet processed and available."

CMS' enrollment procedures and implementation of the Medicare Part D program for dual-eligibles has created "challenges for some dual-eligible beneficiaries, pharmacies, and the Medicare program," according to a report issued by GAO. Not only have CMS' procedures created problems for dual-eligibles attempting to find a prescription drug plan, but the report notes that pharmacies may be affected adversely when "key information about a beneficiary's dual eligibility is not yet processed and available." The report offered a series of recommendations for CMS, including improving communication with dual-eligible beneficiaries and fostering better data sharing between drug plans and the states. That lack of communication may have cost more than 400,000 dual-eligible beneficiaries some federal subsidies. In response, CMS insisted that it has already taken steps to improve notification to dual-eligibles and objected to the "overwhelmingly negative tone to the findings."

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