Medicare Part D policy update
The Centers for Medicare and Medicaid Services issued a policy on April 26 regarding changes to a formulary during a plan year. Previous, a drug plan could drop a drug from its formulary with 60 days notice to the beneficiary. The beneficiary would then be stuck in the plan until the next open enrollment period (November 15, 2006). The policy that was issued now protects beneficiaries.
The new policy says, "No beneficiaries will be subject to a discontinuation or reduction in coverage of the drugs they are currently using." It says an insurer can remove a drug from its formulary, increase copayments for a drug or impose new coverage restrictions "only if enrollees currently taking the affected drug are exempt from the formulary change for the remainder of the plan year." The policy allows some exceptions. For example, an insurer could remove a drug from its formulary if new research shows the drug was unsafe or if a new generic equivalent becomes available.
See the Medicare Part D resources page http://hiv.bvcog.org/2005/11/medicare_part_d_resources.html