Dear independent pharmacy leader,  

NCPA has some updated information from a call today with CMS that we would like to share with you related to the 2015 Aetna / Coventry Part D plans as well as the current and future contracting processes for Part D:

 1)      The time frame for out-of-network pharmacies to submit claims for payment under the Aetna / Coventry Part D plans has been extended beyond February 28, 2015.  A firm date for discontinuation of this ability to submit claims for payment has not been set as Aetna has not concluded its network contracting obligations under the current CAP (Corrective Action Plan).  CMS did indicate that pharmacies will be notified in writing with reasonable time to prepare for the conclusion of that process once a date has been determined.

2)      The SEP (Special Enrollment Period) available to Aetna / Coventry Part D beneficiaries to switch plans should they choose remains open with an indefinite end date.

3)      This week, CMS issued Aetna a new notice of non-compliance under the current CAP that indicated 3 Aetna regional Part D MAPD plans did not meet minimum geo access standards and that they must come into compliance for this year.

4)      NCPA discussed with CMS shortcomings of the 2015 Part D network contracting processes by PBMs to help ensure that similar pharmacy and beneficiary confusion did not repeat itself for the 2016 Part D plan year.   When we have additional pertinent information, we will communicate it to you as we have over the last several months.  

Best regards,  

National Community Pharmacists Association