Ensuring Dual-Eligible Beneficiaries' Access to Drugs Under Part D: Mandatory Review
Dual-eligible beneficiaries are enrolled in Medicaid but qualify for prescription drug coverage under Medicare Part D. As long as Part D plans meet certain limitations outlined in 42 CFR § 423.120, Part D plan sponsors have discretion to include different Part D drugs and drug utilization tools in their formularies. We will review the extent to which drug formularies developed by Part D plan sponsors include drugs commonly used by dual-eligible beneficiaries as required. The Affordable Care Act, § 3313, requires OIG to conduct this review annually.
|Announced or Revised||Agency||Title||Component||Report Number(s)||Expected Issue Date (FY)|
|February 2021||Centers for Medicare and Medicaid Services||Ensuring Dual-Eligible Beneficiaries' Access to Drugs Under Part D: Mandatory Review||Office of Evaluation and Inspections||OEI-05-21-00170||2021|