Pharmacies should know that if a patient has opted in to the Medicare Prescription Payment Plan offered by their Part D plan, all copays for all Part D covered drugs should be submitted to the MPPP processor. Patients who want to pick and choose which copays are submitted may not get the maximum benefit of choosing the MPPP and allowing it may put the pharmacy at risk for audit findings when there is no MPPP claim to match the primary Part D claim.
You can encourage patients to direct questions to their plan’s member helpline or contact CMS by email or at 1-800-Medicare. For more information on the MPPP, including a continuing education program for pharmacists and pharmacy technicians, go to ncpa.org/medicare.
NCPA
