CMS mandates 180-day Part D claims
CMS has mandated that Part D drug plans allow 180 days for filingclaims incurred between Jan. 1 and June 30. Problems withcoordination of benefits have required the reversal of claims andrebilling to the appropriate payer. Since a lack of information ledpharmacies to sometimes bill the wrong payer, they should not beheld to the usual 30- to 90-day timely billing standard, CMSconcluded.
CMS mandates 180-day Part D claims
CMS has mandated that Part D drug plans allow 180 days for filing claims incurred between Jan. 1 and June 30. Problems with coordination of benefits have required the reversal of claims and rebilling to the appropriate payer. Since a lack of information led pharmacies to sometimes bill the wrong payer, they should not be held to the usual 30- to 90-day timely billing standard, CMS concluded. The agency mandated the 180-day window after some Part D plans failed to create appropriate claims filing rules as CMS had requested.
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Challenges for Pharmacies in 2025: What to Expect and How to Prepare
January 8th 2025Pharmacy professionals are used to overcoming obstacles in this competitive, dynamic field. But the coming year will bring challenges affecting patient care, the industry workforce and their business. Pharmacies must be ready to do more than weather the storm; they need deliberate strategy and sophisticated tools to thrive amidst these obstacles. This white paper will discuss the issues and solutions that should be at the top of every pharmacy professional’s mind as they start the new year.
