Medicare Part D Fact Sheet

Medicare Part D Plan Open Enrollment Every October 15 through December 7th Medicare Part D plans have Open Enrollment. The programs begin on January 1st. Medicare Part D is prescription drug coverage with a formulary of prescription drugs, managed by a plan sponsor. If a person participates in Medicare Part A or Part B, then the Part D enrollment is voluntary. If a person has Medicaid, then they must enroll in a Part D plan, or one will automatically be assigned. Medicaid coverage helps with costs of premiums, deductibles and co-pays. FLORIDA APPROVED PART D PLANS FOR 2020 SilverScript Choice Wellcare Classic Cigna Healthspring RX Secure (new for 2020) Clear Spring Health Value RX (new for 2020) Basic Plan for the Average Person Monthly premiums average $30.00 per month Annual deductible is $435.00 Co-pays for prescriptions up to 75% of the cost of drugs (depends on the drug) “Donut Hole” – is a gap in prescription coverage Coverage for drugs stops at $4,020 Beneficiary is responsible for 100% of drug costs from $4,020 until $6,350 out of pocket Once the annual cost of drugs reaches $6,350, Medicare Part D pays 95% of costs        During Open Enrollment Oct – Dec Letters will be mailed to all “choosers” regarding their status The designated person that choose a plan any year since



Medication Management Program

On October 1,  2018, data will be collected to ensure that medication reconciliation is also completed at the time of admission.  The new Quality Measure – Drug Regimen Review, will evaluate the percentage of resident stays in which drug regimen review was conducted at time of admission and if facility staff followed up with the physician before midnight the next calendar day.   Facilities that are found non-compliant will have their Medicare Payment reduced 2%. Skilled nursing facilities are required to reconcile patient medications prior to discharge back to the community.  F661 – Discharge Summary states “Facility staff must compare the medications listed in the discharge summary to medications the resident was taking while in the facility.  Any discrepancies must be assessed and resolved, and resolution documented in discharge summary with rationale.” The Advancing Excellence “Medications at Transitions and Clinical Handoffs” (MATCH) toolkit incorporated experiences and lessons learned from staff of facilities that have implemented MATCH.  The toolkit helps facilitate a review and improvement of current practices to strengthen the process and improve patient safety. The World Health Organization has developed a Standard Operating Protocol for Medication Reconciliation and assuring medication accuracy in transitions in care. To write your policy and start your program, click the link below:  

F TAGs for Pharmacy Services

TAG REGULATION OLD TAG F554 Self-Admin Meds F176 F694 IV Fluids F328 F697 Pain Management F309 F755 Pharmacy Services F425,F431 F756 Drug Regimen Review F428 F757 Unnecessary Drugs F329 F758 Psychotropic Meds F329,F428 F759 Med Error Rate F332 F760 Significant Med Errors F333 F761 Label/Storage Drugs F431 F773 Notify of Lab Results F504,F505 F881 Antibiotic Stewardship new F882 Infection Preventionist new F883 Immunizations F334 F945 Infection Control Train new

ASK THE PHARMACIST…about national drug shortages

Question:  I have an IV antibiotic ordered and the pharmacy informed me that the drug is not available because of a national backorder, what does that mean? Answer:  From time to time there are national shortages on medications mainly due to manufacturing issues. The FDA website explains drug shortages like this: When one company has a problem or discontinues manufacturing a drug, it is difficult for the remaining drug companies to increase production quickly and a shortage occurs. Hospital pharmacies have priority and are the first to receive medications after production and other pharmacies are placed on a waiting list.  In nursing homes, communication is key to prevent adverse drug therapy or delay medical treatment. Upon admission to the nursing home it is important to review hospital records and the pharmacy can recommend alternative medications based on lab tests. (Culture & Sensitivity) to determine which antibiotics would be an acceptable. Share this link to educate your staff. Bookmark this FDA Website to check national shortages: