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Arlington, Va. — The National Association of Chain Drug Stores (NACDS) has written to the Centers for Medicare & Medicaid Services (CMS) to “recommend administrative changes to facilitate a smooth start for new exchange enrollees seeking prescription drug coverage in the 2015 plan year.”
“We recommend that exchange call centers remain open on all federal and state holidays during the December/January period, that exchange plan beneficiary eligibility files are updated on a nightly basis, and that functionality is implemented to allow pharmacists to use one-time overrides in the month of January where they have difficulty adjudicating claims for new exchange enrollees,” NACDS wrote to CMS Administrator Marilyn Tavenner.
NACDS detailed the technical rationale for each of its recommendations, with a focus on optimizing the experience of patients during this next transition phase for millions of Americans:
NACDS’ recommendations reflect its engagement in late 2013, when the Association advised the agency of steps necessary to improve the January 1, 2014, roll-out of exchange-based insurance coverage as a result of the Affordable Care Act (ACA).
In 2013, NACDS conducted extensive outreach with members to help identify and solve potential difficulties related to the exchange roll-out, and to maintain open communication throughout its implementation. NACDS also participated in regular White House meetings and conference calls as the calendar turned from 2013 to 2014, and was invited to a White House event in May 2014 with President Obama and the First Lady to thank those who worked to smooth the experience of patients during the transition.
NACDS has likened pharmacy’s ACA implementation to pharmacy’s education efforts during the 2006 rollout of Medicare Part D, the response to H1N1, a consistent and concerted national flu vaccination campaign, and the providing of necessary goods and services during national crisis situations.
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