Michigan Medicaid

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Topic
Topic
Procedure for Beneficiaries with coverage gap CMS has developed a process for a point of sale solution to ensure full dual eligible individuals experience no coverage gap. If a beneficiary presents at a pharmacy with evidence of both Medicare and Medicaid eligibility, but they are not currently enrolled in a Part D plan, they can have the claim for their medication submitted to a single account for payment. This would allow the beneficiary to leave the pharmacy with their prescription. CMS is contracting with 2 vendors to coordinate eligibility verification and expedite the enrollment process. Click here for additional information on the basics of the contingency plan. Pharmacies can click here for further information on the actual steps of the point-of-sale faciliated enrollment process.
Reminder: Information on Medicare Parts D & B Information on Medicare Part D and Medicare Part B are located on the Home Page of this website, including helpful links, documents and phone numbers. Please click on the "home" icon above to return to that location.
Notice of September 10, 2009 Pharmacy Provider Liaison Meeting
Agenda for June 11, 2009 Pharmacy Provider Liaison Meeting
Schedule for 2009 Pharmacy Provider Liaison Meetings
Reminder: Holidays & Provider Checks Providers may experience a day or two lag in receiving their reimbursement when major Holidays occur on or near the days that Provider Checks are created and/or mailed (e.g. Thanksgiving, Christmas, and New Years).
Additional Information on Billing Medicare/Medicaid COB Claims
Dose Optimization Program
MAC Price List
Implementation of 835 RA
Clinical Alerts

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