Medicare Delayed Part D Rule; Don’t Delay Your Enrollment

The Centers for Medicare & Medicaid Services (CMS) has again delayed its deadline for physicians, nonphysician practitioners, and others who write prescriptions for Part D drugs to be enrolled in Medicare* for the prescriptions to be covered under Medicare Part D

CMS has moved the deadline from Feb. 1, 2017, to Jan. 1, 2019. Medicare will deny your Medicare patients’ prescription drug claims starting Jan. 1, 2019, if you are not enrolled.

It’s not too early to enroll if you haven’t already. In addition, be sure any nonphysician practitioners who write prescriptions in your practice are enrolled.

To enroll, submit a Medicare enrollment application to Novitas Solutions. You may submit your application electronically using the Provider Enrollment, Chain, and Ownership System (PECOS). This generally is the faster method; use the PECOS enrollment guide developed for Part D prescribers. Or, complete one of the paper applications.

  • Complete the CMS-855O to enroll in Medicare for the limited purpose of prescribing. The CMS-855O form is an abbreviated form.  
  • Complete the CMS-855I to enroll in Medicare to bill and receive payment for Medicare-covered services and for prescribing.   

Visit the Novitas Part D Prescriber Enrollment webpage, and use the decision matrix to help you with your enrollment decision. If you have questions, contact Novitas Solutions at (855) 252-8782 Monday through Friday, 7 am–3 pm CT.

* You may either enroll in Medicare or validly opt out. Review CMS guidance thoroughly before electing to opt out.

Send your hardcopy enrollment application or opt out affidavit to: Novitas Solutions, Provider Enrollment Services, PO Box 3095, Mechanicsburg, PA 17055-1813.

As always, be sure to monitor your application through completion.

Revised Nov. 14, 2016

TMA Practice E-Tips main page

Last Updated On

November 14, 2016

Originally Published On

December 10, 2014

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