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Due Diligence in Prior Authorization of Part B versus Part D Coverage Determinations

Please see the attached from Gary Bailey, Deputy Director, Center for Beneficiary Choices.

Attached you will find an important Q & A from CMS that addresses the issue of what further due diligence is required of the Part D plan for making a determination of Part D coverage when a physician includes additional information on a prescription that is sufficient to determine whether the drug is covered.

Thank you.