Part D plans must use standard Rx claim codes

May 30, 2006

Beginning July 1, all Medicare Part D drug plans must use approvedstandardized reject codes developed by groups representingpharmacy, PBMs, and insurers. The change from best practice tomandate was announced by CMS administrator Mark McClellan, who saidit is fundamentally important to reduce administrative burdens onpharmacists.

Beginning July 1, all Medicare Part D drug plans must use approved standardized reject codes developed by groups representing pharmacy, PBMs, and insurers. The change from best practice to mandate was announced by CMS administrator Mark McClellan, who said it is fundamentally important to reduce administrative burdens on pharmacists. Other standard codes and messaging being developed will become Medicare requirements 90 days after they are approved by the National Council for Prescription Drug Programs.

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