If you've been relying on phone calls from Optum or other Medicare Part D Plans to get opt-in updates and processing information for the Medicare Prescription Payment Program (M3P), you need to take immediate action to make automated notifications in paid claim responses do the work for you. NCPA is aware of compliance notices sent to pharmacies in recent days that mention termination from the Part D network as a potential penalty.
Contact your dispensing system vendor's customer support to learn about solutions for Approved Message Code 057, Beneficiary participating in Prescription Payment Plan. Patients who switched plans or opted in to M3P for the first time this year will need to have the processing information added to their profile — and your vendor can help you get the processing information out of the paid claim responses too. Patients who change their mind and no longer want to participate in M3P can contact their plan to opt out. NCPA previously covered this issue here. You can also contact us at [email protected] with "M3P" in the subject line.
