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.