Rural resources on Medicare Part D Prescription Drug Benefit resources related to rural health and human services, with information provided by the Rural Assistance Center Copyright 2009 Rural Assistance Center http://www.raconline.org/info_guides/partd/ Offers general information about certain aspects of the Medicare program including enrollment, reimbursement, payment policies, evaluation and management services, protecting the Medicare Trust Fund, and inquiries, overpayments and fee-for-service appeals. -- Centers for Disease Control and Prevention http://www.cms.hhs.gov/MLNProducts/downloads/physicianguide.pdf Mon, 26 Oct 2009 14:40:35 CST http://www.cms.hhs.gov/MLNProducts/downloads/physicianguide.pdf The proposed revisions from the Centers for Medicare & Medicaid Services clarify various program participation requirements; specify changes to strengthen beneficiary protections; ensure that plan offerings to beneficiaries include meaningful differences; improve plan payment rules and processes; and implement new policy such as a Part D formulary policy. http://edocket.access.gpo.gov/2009/E9-24756.htm Thu, 22 Oct 2009 09:33:13 CST http://edocket.access.gpo.gov/2009/E9-24756.htm Describes the major Medicare provisions relating to benefit changes, Medicare Advantage, the Medicare prescription drug benefit, physician and other provider payment reforms, and other health system reforms in the Senate Finance proposal and the House Tri-Committee bill. -- Kaiser Family Foundation http://www.kff.org/healthreform/upload/7948-3.pdf Wed, 23 Sep 2009 07:59:24 CST http://www.kff.org/healthreform/upload/7948-3.pdf Reports that private fee-for-service (PFFS) plans dominate enrollment in rural areas and have accounted for much of the program's expansion since 2005. However, from December 2008 through April 2009 enrollment growth of preferred provider organization (PPO) plans, both nationally and in rural areas, was double the enrollment growth of PFFS plans. -- RUPRI Center for Rural Health Policy Analysis http://www.unmc.edu/ruprihealth/Pubs/MonthlyMAUpdates/April%202009%20MA%200508.pdf Fri, 15 May 2009 13:16:55 CST http://www.unmc.edu/ruprihealth/Pubs/MonthlyMAUpdates/April%202009%20MA%200508.pdf An overview of the Medicare Advantage program, and includes legislative history, analysis of recent trends and includes rural issues. -- Congressional Research Service http://assets.opencrs.com/rpts/R40374_20090303.pdf Sat, 04 Apr 2009 20:57:25 CST http://assets.opencrs.com/rpts/R40374_20090303.pdf Reports that rural beneficiaries are more likely to enroll in stand-alone prescription drug plans (PDPs), while urban beneficiaries are much more likely to enroll in Medicare Advantage (MA) plans that offer prescription drug coverage (MA-PD plans). -- RUPRI Center for Rural Health Policy Analysis http://www.unmc.edu/ruprihealth/Pubs/b2009-2%20Medicare%20Part%20D.pdf Wed, 18 Mar 2009 15:38:09 CST http://www.unmc.edu/ruprihealth/Pubs/b2009-2%20Medicare%20Part%20D.pdf Reports that rate of growth of rural enrollment in the Medicare Advantage program decreased significantly in 2008, compared to previous years. In addition, the growth rate in preferred provider organization plans in rural areas now exceeds that in private fee-for-service plans. -- RUPRI Center for Rural Health Policy Analysis http://www.unmc.edu/ruprihealth/Pubs/b2009-1%20MA%202008.pdf Wed, 18 Mar 2009 15:31:13 CST http://www.unmc.edu/ruprihealth/Pubs/b2009-1%20MA%202008.pdf Provides information and data about the Medicare Drug Benefit, including 2009 plan information, a breakdown of the standard benefit, updates on additional low-income assistance, and the latest available enrollment data -- Kaiser Family Foundation http://www.kff.org/medicare/upload/7044-10.pdf Mon, 09 Mar 2009 09:38:15 CST http://www.kff.org/medicare/upload/7044-10.pdf Examines the extent to which the Medicare drug benefit reduced the burden of health care costs for seniors in 2006, the first year in which it was in effect, using data from the Bureau ofLabor Statistics Consumer Expenditure Survey. -- Center for Economic and Policy Research http://www.cepr.net/documents/publications/Impact-of-Medicare-Drug-Benefit-2008-12.pdf Wed, 18 Feb 2009 09:10:12 CST http://www.cepr.net/documents/publications/Impact-of-Medicare-Drug-Benefit-2008-12.pdf Describes pharmacy Prescription Drug Plan (PDP) contract patterns of sole rural pharmacies. Addresses PDP enrollment choices of Medicare Part D enrollees. -- North Carolina Rural Health Research and Policy Analysis Center (Cecil G. Sheps Center) http://www.shepscenter.unc.edu/research_programs/rural_program/pubs/report/FR95.pdf Tue, 27 Jan 2009 09:45:25 CST http://www.shepscenter.unc.edu/research_programs/rural_program/pubs/report/FR95.pdf Discusses the Medicare Part D low-income supplement (LIS), which is designed to help low-income persons access the prescription drug benefit with reduced premiums and lower out-of-pocket costs. -- RUPRI Center for Rural Health Policy Analysis http://www.unmc.edu/ruprihealth/Pubs/LIS%20Brief%202008-5.pdf Thu, 11 Dec 2008 16:08:18 CST http://www.unmc.edu/ruprihealth/Pubs/LIS%20Brief%202008-5.pdf Overview of the Medicare Part D prescription drug benefit. Includes information on Medicare subsidies, Medicare payments to plans, and the calculation of enrollee premiums. -- Medicare Payment Advisory Commission http://www.medpac.gov/documents/MedPAC_Payment_Basics_08_PartD.pdf Thu, 09 Oct 2008 09:04:37 CST http://www.medpac.gov/documents/MedPAC_Payment_Basics_08_PartD.pdf Overview of Medicare payments to Medicare Advantage (MA) plans. Includes information on Medicare Advantage regions. -- Medicare Payment Advisory Commission http://www.medpac.gov/documents/MedPAC_Payment_Basics_08_MA.pdf Thu, 09 Oct 2008 09:00:31 CST http://www.medpac.gov/documents/MedPAC_Payment_Basics_08_MA.pdf Provides findings about enrollment in the Medicare Advantage program in rural areas and across the United States. -- RUPRI Center for Rural Health Policy Analysis http://www.unmc.edu/ruprihealth/Pubs/b2008-3%20MA%20Enrollment.pdf Mon, 25 Aug 2008 12:39:50 CST http://www.unmc.edu/ruprihealth/Pubs/b2008-3%20MA%20Enrollment.pdf Provides the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) that passed by both Houses. http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=110_cong_bills&docid=f:h6331enr.txt.pdf Tue, 19 Aug 2008 10:05:34 CST http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=110_cong_bills&docid=f:h6331enr.txt.pdf Analyzes recent developments in the Medicare Advantage marketplace, including plan choices available to beneficiaries and enrollment trends by plan type and geography including rural issues. -- Kaiser Family Foundation http://www.kff.org/medicare/upload/7775.pdf Thu, 05 Jun 2008 11:40:27 CST http://www.kff.org/medicare/upload/7775.pdf Analyzes the relationship between Medicare Part D payments, excluding dispensing fees, to local, community pharmacies and the pharmacies drug acquisition costs. Estimate Part D dispensing fees and compares them with Medicaid dispensing fees. Includes some data specific to rural pharmacies. -- U.S. Department of Health and Human Services http://www.oig.hhs.gov/oas/reports/region6/60700107.pdf Mon, 14 Jan 2008 09:31:06 CST http://www.oig.hhs.gov/oas/reports/region6/60700107.pdf Describes the experiences of 51 rural independently-owned pharmacies that are the sole providers of pharmacy services in their community one year after implementation of the Medicare Part D prescription drug benefit. A final report is also available. http://www.shepscenter.unc.edu/research_programs/rural_program/pubs/finding_brief/FB83.pdf Fri, 26 Oct 2007 09:00:06 CST http://www.shepscenter.unc.edu/research_programs/rural_program/pubs/finding_brief/FB83.pdf Describes the experiences of 51 rural independently-owned pharmacies that are the sole providers of pharmacy services in their community one year after implementation of the Medicare Part D prescription drug benefit. A findings brief is also available. http://www.shepscenter.unc.edu/research_programs/rural_program/pubs/report/FR92.pdf Fri, 05 Oct 2007 09:39:57 CST http://www.shepscenter.unc.edu/research_programs/rural_program/pubs/report/FR92.pdf Toolkit for organizations interested in helping Medicare beneficiaries who qualify for the low income subsidy (LIS) to learn about and apply for extra help in paying for prescription drugs. -- Centers for Medicare and Medicaid Services http://www.cms.hhs.gov/Partnerships/Toolkits/itemdetail.asp?itemID=CMS1188820 Thu, 26 Jul 2007 08:52:07 CST http://www.cms.hhs.gov/Partnerships/Toolkits/itemdetail.asp?itemID=CMS1188820 Shows the percent of rural people enrolled in a Medicare Part D prescription drug program as of June 2006, based on data from the Centers for Medicare and Medicaid Services. -- RUPRI Center for Rural Health Policy Analysis http://www.unmc.edu/ruprihealth/Pubs/PDF%20of%20All%20Color%20Maps.pdf Mon, 23 Jul 2007 10:26:02 CST http://www.unmc.edu/ruprihealth/Pubs/PDF%20of%20All%20Color%20Maps.pdf Office of Inspector General report discussing the extent to which retail pharmacies participate inMedicare Part D stand-alone prescription drug plans (PDPs). Includes comparison of pharmacy participation rates among metropolitan and non-metropolitan pharmacies. -- U.S. Department of Health and Human Services http://www.oig.hhs.gov/oei/reports/oei-05-06-00320.pdf Fri, 20 Jul 2007 08:35:50 CST http://www.oig.hhs.gov/oei/reports/oei-05-06-00320.pdf Provides information on a series of CMS forums addressing pharmacy issues. Includes call-in instructions for the next call, how to register for the mailing list, and links to pharmacy-related fact sheets. -- Centers for Medicare and Medicaid Services http://www.cms.hhs.gov/OpenDoorForums/22_ODF_PPDM.asp#TopOfPage Mon, 02 Jul 2007 10:38:12 CST http://www.cms.hhs.gov/OpenDoorForums/22_ODF_PPDM.asp#TopOfPage Provides information for health plans regarding how to implement CMS policies and procedures and comply with critical program requirements for the 2008 contract year. Includes detailed information on the Medicare Advantage (Part C) and prescription drug (Part D) programs. -- Centers for Medicare and Medicaid Services http://www.cms.hhs.gov/PrescriptionDrugCovContra/Downloads/CallLetter.pdf Fri, 22 Jun 2007 10:35:11 CST http://www.cms.hhs.gov/PrescriptionDrugCovContra/Downloads/CallLetter.pdf Information for current and future contracting Medicare Advantage Organizations, other health plans, and other parties interested in the operational and regulatory aspects of the Medicare Advantage program. -- Centers for Medicare and Medicaid Services http://www.cms.hhs.gov/HealthPlansGenInfo/ Fri, 22 Jun 2007 10:28:14 CST http://www.cms.hhs.gov/HealthPlansGenInfo/ Identifies sections of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) that might be of special concern to rural Medicare beneficiaries, medical care providers, and policymakers. Includes guidance regarding provisions in the Proposed Rule "Establishment of the Medicare Advantage Program," which implements Title II of the MMA, with a focus on its impact on rural health service delivery. -- NORC Walsh Center for Rural Health Analysis http://www.unmc.edu/ruprihealth/Pubs/P2004-6.pdf Tue, 19 Jun 2007 13:14:57 CST http://www.unmc.edu/ruprihealth/Pubs/P2004-6.pdf Examines out-of-pocket spending on prescription drugs by noninstitutionalized rural Medicare beneficiaries age 65 and older. Includes information on supplemental insurance coverage among rural and urban Medicare beneficiaries. -- AARP Public Policy Institute http://www.aarp.org/research/ppi/health-care/medicare/articles/prescription_drug_spending_and_coverage_among_rura.html Tue, 19 Jun 2007 13:12:27 CST http://www.aarp.org/research/ppi/health-care/medicare/articles/prescription_drug_spending_and_coverage_among_rura.html Provides information and data about the Medicare Drug Benefit, including a breakdown of the standard benefit and updates on additional low-income assistance. -- Kaiser Family Foundation http://www.kff.org/medicare/7044.cfm Tue, 19 Jun 2007 13:11:32 CST http://www.kff.org/medicare/7044.cfm Early information on enrollment in the Medicare prescription drug program in rural and urban areas. Includes findings from ananalysis of plans available to rural persons underMedicare's Part D program. -- RUPRI Center for Rural Health Policy Analysis http://www.unmc.edu/ruprihealth/Pubs/Medicare_Part_D_brief.pdf Tue, 19 Jun 2007 13:10:41 CST http://www.unmc.edu/ruprihealth/Pubs/Medicare_Part_D_brief.pdf Includes key messages for HRSA Grantees, along with links and information about Medicare Part D reimbursement. -- Office of Rural Health Policy http://networkassist.ruralhealth.hrsa.gov/documents/medicare%20info%20for%20grantees%20may%202006.pdf Tue, 19 Jun 2007 13:10:17 CST http://networkassist.ruralhealth.hrsa.gov/documents/medicare%20info%20for%20grantees%20may%202006.pdf