The Centers for Medicare and Medicaid Services finalized a rule in March 2014 that required healthcare providers prescribing medication, where the prescription is paid for by a Medicare Part D plan, to enroll in Medicare as a prescriber. The enforcement date has been delayed several times and was slated to take effect on February 1, 2017, but has recently been delayed again until January 1, 2019.

 

Under the final rule, if a provider is not enrolled in Medicare as a prescriber, the patient’s prescribed drugs will not be covered by the Part D plan. Part D plans will be required to notify patients that the prescriber is not enrolled and the plan will not cover prescriptions from that provider. The most recent delay is aimed at ensuring that prescribers are aware of the rule and reduce the immediate burden placed on the estimated 250,000 prescribers not enrolled in Medicare and the 5.25 million beneficiaries that would be impacted.  

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