Performance Improvement 2009. Do Nursing Homes and Long-Term Care Pharmacies Assist Their Medicare-Medicaid Dual-Eligible Residents to Select Prescription Drug Payment Plans?


The study analyzed structured interviews with a sample of nursing home administrators and directors of operations for long term care pharmacies.

Some of the practices identified may not be in accordance with CMS guidance that nursing homes not request, require, coach, or steer residents to particular plans. Nursing homes and long term care pharmacies provide different types of assistance to dual-eligible residents who are selecting their Part D plans. Thirty-eight percent of nursing home administrators and thirty-three percent of pharmacy directors reported that their pharmacies identified multiple plans that met dual-eligible residents’ needs or provided a general list of plans that the pharmacy recommended to all residents. About nine percent of nursing home administrators and eight percent of pharmacy directors reported enrolling most dual-eligible residents in a single plan or recommended one plan to each resident. The remaining administrators and directors reported that they provided only general information about the benefit or no assistance.

Report Title: Role of Nursing Homes and Long Term Care Pharmacies in Assisting Dual-Eligible Residents With Selecting Part D Plans
Agency Sponsor: OS-OIG, Office of Inspector General
Federal Contact: Erin Lemire, 202-205-9523
Performer: Staff; Office of Inspector General
PIC ID: 8981

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