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AHIP Member Plans Work with AMA, Beneficiary Groups to Simplify Medicare Part D Administration
Exceptions Form
(.doc - 71 KB)
Standard authorization form for non-formulary drugs
Ignagni: “This effort demonstrates what our community can do collaboratively to streamline administrative processes”
WASHINGTON, DC – In a joint effort to simplify administration of the new Medicare prescription drug program, America’s Health Insurance Plans (AHIP), today announced that it has collaborated with the American Medical Association (AMA) and other allies to develop a standardized form that physicians can use to request prior authorization and coverage for non-formulary drugs.
AHIP President and CEO Karen Ignagni made the following comments:
“In mid-January, our members directed AHIP to establish several advisory councils to reach out to beneficiary groups, pharmacy organizations and physicians with the goal of working collaboratively to simplify administrative processes in the Medicare prescription drug program and, where possible, create uniform administrative procedures.
“With today’s announcement of a common form that physicians can use to request an exception and coverage for non-formulary drugs, we are unveiling the first product of the advisory councils’ fast-track process for simplification. AHIP and its members have worked in tandem with a special committee established by the AMA to quickly and effectively work through the issues surrounding exceptions and appeals.
“This effort demonstrates what our community can do collaboratively to streamline administrative processes. It is the first in a series of simplification efforts designed to ensure that the Medicare prescription drug program works even more effectively for beneficiaries, physicians and pharmacists.”
AHIP and the AMA have transmitted the new form to the Centers for Medicare and Medicaid Services (CMS). Many health insurance plans are expected to begin incorporating this new form immediately. It can be found at www.ahip.org or www.cms.gov.
