The top three things to know about the Medicare GLP-1 Bridge, an 18-month program that covers GLP-1 drugs with a $50 copay for eligible patients Medicare Part D plan that starts on July 1 are: 1) total reimbursement to the pharmacy for the GLP-1 drug NDCs in the program is WAC + $3 within 14 days, 2) the Bridge has an open network, and pharmacies can submit claims via a payer sheet, and 3) there is a prior authorization process to ensure appropriate utilization.
You can find the payer sheet here. CMS has more details on the Medicare GLP-1 Bridge on its website. NCPA members can also watch the webinar NCPA hosted with CMS experts here.
If you need help with your NCPA member login, chat with us online or email membership@ncpa.org.
New this week is a CMS page for Medicare beneficiaries, including an eligibility wizard. Try it out at https://www.medicare.gov/coverage/weight-loss-drugs and share it to your social media.
