Medicare Part D: selected issues for plan sponsors, pharmacists, and beneficiaries in 2009

The Medicare Drug Benefit was designed to provide coverage for outpatient prescriptions to Medicare beneficiaries. Since its inception in January 2006, there have been numerous refinements; however, the overall purpose and structure of the benefit remain the same.

To (1) review changes to the benefit for 2009 and (2) describe the Part D provisions of the Medicare Improvements for Patients and Providers Act of 2008.

We reviewed policy statements and other communications from the Centers for Medicare & Medicaid Services released between January 1, 2008, and September 30, 2008, and the Medicare Improvements for Patients and Providers Act of 2008.

Changes to Part D in 2009 include availability of Part D data, changes in the coverage amounts in the standard drug benefit, outreach to vulnerable populations, the United States Pharmacopeia 3-year cycle, revisions to the best-available-evidence policy, new standards for e-prescribing, and new guidance for medication therapy management programs.

Various refinements and clarifications to the benefit have been made to date; however, opportunities for improvement remain. The availability of Part D data will allow researchers to determine the impact of drugs on overall health outcomes and costs for Medicare beneficiaries.