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Advocacy News

CMS Announces Significant Timetable Change for Prescribers of Medicare Part D Drugs

December 16, 2014

This past May the Centers for Medicare and Medicaid Services (CMS) published a final rule that requires dentists who prescribe Part D covered drugs to be enrolled in Medicare or opt out for those prescriptions to be covered under Part D.

The ADA has actively opposed this provision as it applies to dentists and is currently seeking an exemption for the dental profession. The ADA has advocated against this rule on behalf of members directly to CMS and through the House Small Business Committee, the Small Business Administration, and the SBA’s Ombudsman office. Most recently, through a letter dated Nov. 5, the ADA has brought this issue to the attention of CMS Administrator Marilyn Tavenner. We are currently preparing for a Jan. 8 meeting with CMS to continue to advocate against this rule.  

The good news is that very recently CMS delayed the enforcement date, allowing the ADA additional time to address its concerns in the new Congress.  Although the enrollment deadline remains June 1, 2015, the rule will not be enforced until Dec. 1, 2015.  

While we continue to advocate for a dental exemption, it is also important to educate dentists on this rule. For example, opting in or out has implications for other Medicare services such as those offered through Medicare Advantage plans. We are sensitive of the need to balance member education with advocacy efforts in cases like this, where the outcome is unpredictable because of the changing political balance in Washington D.C.

The ADA’s Practice Institute has a short primer Q & A on this topic that refers to additional information and an infographic on enrolling or opting out of Medicare.
We will keep you apprised of the ADA’s advocacy efforts as well as your possible filing requirements in the future.