Physicians and other eligible professionals prescribing Medicare Part D drugs should be enrolled in Medicare by Aug. 1 in order to have the drugs covered by the program after Feb. 1, 2017.
The CMS had been concerned about instances in which unqualified individuals were prescribing Part D drugs. Agency officials say stronger oversight will help reduce deaths related to opioid abuse and misuse.
“CMS wants to be able to address these few prescribers that are abusing the system and feeding this epidemic or committing other types of fraud,” said Dr. Shantanu Agrawal, director of the CMS' Center for Program Integrity.
The 2014 final rule cited a report by HHS' Office of Inspector General that found abuses in prescription practices by some physicians. For instance, 108 physicians ordered an average of 71 prescriptions per Medicare beneficiary—or five times the national average.
In data released by the agency last year, it estimated that in 2016 as many as 250,000 prescribers not enrolled in Medicare would be writing prescriptions for 5.25 million beneficiaries. The average Part D beneficiary takes nine drugs prescribed by three prescribers annually.
The CMS delayed the enforcement date three times to expand outreach and education efforts. The agency said it felt an obligation to minimize disruption of beneficiaries' access to medications.
