CMS updates COVID-19 guidance to Medicare Advantage and Part D plans

NCPA April 23, 2020

On April 21, CMS released a guidance document to Medicare Advantage organizations, Part D sponsors, and Medicare-Medicaid plans updating previously released information from March 10. The guidance includes several relevant provisions for community and long-term care pharmacies, including:

  • Coverage of testing and testing-related services for COVID-19

  • Relaxed enforcement of signature log and prior authorization requirements

  • Suspension of plan-coordinated pharmacy audits

  • Requirement for Part D sponsors to permit 90-day fills, refills, or transition fills

  • Relaxation of short-cycle fill requirements for LTC patients.

NCPA successfully advocated that CMS temporarily waive Part D medication delivery documentation and signature log requirements during the public health emergency and adopt a temporary policy suspending plan-coordinated pharmacy audits. NCPA also successfully advocated for community and LTC pharmacies regarding relaxing prior authorization, point-of-sale edits, and short-cycle dispensing requirements. For more information, see NCPA's member summary.