March 2015

In this issue

//  Medicare change may require action

We're serious about security

TriState Advantage network improves access

HMP provider copay obligations

Rethink Your Drink materials remain available

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Medicare change may require action

A change in the Medicare Part D prescription program requires dentists to take action before June 1, 2015.

Compliance with the new regulation ensures that prescriptions you prescribe to Medicare beneficiaries will be covered by the program.

Dentists must do one of the following to ensure their prescriptions are covered: enroll as a Medicare provider, or actively opt out of Medicare by filing an affidavit. If you are already enrolled with Medicare, no further action is required.

The Centers for Medicare and Medicaid Services (CMS) issued the regulation change in May 2014.

If you do not comply with the regulation, prescriptions that you write for your Medicare beneficiaries may not be covered. Please also note that if you elect to opt out, you may not be able to receive direct or indirect Medicare payments for two years. This could impact the payments you receive from Medicare Advantage plans covering dental as a supplemental benefit.

To opt in as a Medicare provider, use CMS Form 855I.

If you have questions or need additional information regarding Medicare, the American Dental Association (ADA) provides resources for its members. The ADA materials can be found here.

Action is recommended before June 1, 2015. The CMS regulation goes into effect December 1, 2015.

Delta Dental of Michigan, Ohio, and Indiana