Update on Medicare Part D Enrollment for Dentists

The Centers for Medicare and Medicaid Services (CMS) has once again delayed the implementation of ruling CMS-1459-F that calls for all providers (including dentists) who write prescriptions for Medicare beneficiaries to be enrolled in Medicare or have a valid opt out form on file with CMS.  The new deadline is February 1, 2017.


The intent of the ruling is to fight fraud in the Medicare Part D program, according to CMS.  However, the American Dental Association continues to lobby CMS to exclude dentists from the regulations since the vast majority of dentists do not participate in Medicare.  Given that the deadline has been pushed back several times (the original deadline was December 1, 2015), you may think that you can ignore the ruling altogether, but CMS appears intent on including dentists in their efforts to identify fraud—remember that the bill to fight Medicare fraud was a bipartisan effort in Congress.

CMS recommends that dentists enroll in Medicare Part D through the PECOS system.  Keep in mind this does not mean you are enrolled as a Medicare provider; instead by enrolling in Medicare Part D you can write prescriptions for Medicare patients and they in turn can receive reimbursement from Medicare.  If you are not enrolled in Medicare Part D, your Medicare patients cannot receive reimbursement from Medicare for prescriptions you write.


You can find out more information about Medicare Part D enrollment on the CMS website.  CMS recommends that you submit your application as soon as possible to allow time for processing.

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