Medicare Compliance & Reimbursement
E-Benefit Coordinaton To Coincide With New Rx Plan
The Centers for Medicare and Medicaid Services wants to start a new coordination of benefits system to help Medicare patients lower out-of-pocket drug expenses under the Medicare prescription drug benefit effective Jan. 1, 2006.
CMS will contract with Atlanta-based NDCHealth to provide electronic services for the coordination of drug benefits system, according to a May 23 press release.
The company will also route claims for non-Medicare drug payments back to the prescription drug plans. This new system will "combine drug payments from Medicare with payments from other sources without the need for paper - no matter which pharmacy a beneficiary chooses to use," says CMS Administrator Mark McClellan.
How: NDCHealth's contract with CMS requires the company to develop an electronic system similar to what pharmacies use to bill prescription drug claims to insurance plans.
The system should combine beneficiaries' Medicare and other coverage sources to protect them from excess prescription charges, CMS says. The contract includes three one-year extensions and $3.9 million for processing transactions during one year.
Medicare Compliance & Reimbursement
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