The American Psychiatric Association (APA) has updated its Privacy Policy and Terms of Use, including with new information specifically addressed to individuals in the European Economic Area. As described in the Privacy Policy and Terms of Use, this website utilizes cookies, including for the purpose of offering an optimal online experience and services tailored to your preferences.

Please read the entire Privacy Policy and Terms of Use. By closing this message, browsing this website, continuing the navigation, or otherwise continuing to use the APA's websites, you confirm that you understand and accept the terms of the Privacy Policy and Terms of Use, including the utilization of cookies.

×
Psychiatric Practice & Managed CareFull Access

Need Help With Part D Problems?

Published Online:https://doi.org/10.1176/pn.42.7.0017b

Staff from APA's Office of Healthcare Systems and Financing (OHSF) meet regularly with Part D policymakers from the Centers for Medicare and Medicaid Services (CMS) in an effort to ensure Medicare beneficiaries are able to access the psychiatric medications they require.

In 2006 OHSF heard from a large number of physicians about problems they were encountering. Through frequent communications with CMS, OHSF staff were able to get a number of problems cleared up on an individual basis—such as when prescription drug plans (PDPs) were not complying with CMS guidance about continuing coverage for psychotropic drugs on which patients were stabilized or when PDPs were charging inappropriate copays for patients with low-income subsidies. Staff were also able to get clarification on a number of policy issues that helped to protect access.

OHSF would like to keep the pressure on CMS for 2007 if Part D is still making it difficult for patients to access the psychiatric drugs they're entitled to. Here is the specific information OHSF needs:

The name of the patient's Part D plan

The name of the drug to which the patient is being denied access

The reason that access was denied

Your contact information

Please e-mail this information to or call (866) 882-6227, and a member of OHSF staff will contact you if necessary.