Department of Health & Human Services

DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, Maryland 21244-1850 CENTER FOR MEDICARE TO: All Part D Plan Sponsors FROM: Cynthia G. Tudor, Ph.D., Director, Medicare Drug Benefit and C & D Data Group Cheri Rice, Director, Medicare Plan Payment Group SUBJECT: Reminder of the Waiver for Short-Cycle Dispensing by Pharmacies Servicing ICF/MRs and IMDs and for I/T/U Pharmacies and Clarification of the Reporting for New Prescription Drug Event Fields DATE: February 7, 2013 Waiver of Short-Cycle Dispensing Requirements In our 4144 Final Rule (76 FR 21432) published April 15, 2011, we added a new regulation at §423.120(c) to require effective January 1, 2013 that all pharmacies servicing long-term care facilities to dispense solid oral doses of brand-name drugs in no greater than 14-day increments at a time. With this memorandum we remind Part D sponsors that, in accordance with § 423.154 (c), these requirements are waived for pharmacies when they service intermediate care facilities for the mentally retarded (ICFs/MR) and institutes for mental disease (IMDs) as defined in § 435.1010, and for I/T/U pharmacies as defined in § 423.100. To assist sponsors in identifying the IMD facilities, we have attached a list of IMDs. Please note this is not a comprehensive list of all licensed IMDs, but includes those in State Hospitals. Note as well that both Greil Hospital and Searcy Hospital in Alabama recently closed. Clarification of PDE Reporting for Claims for Beneficiaries in an ICF/MR or IMD With this memorandum we also clarify certain PDE reporting requirements when the beneficiary resides in an ICF/MR or IMD. In our memorandum dated October 1, 2012, entitled “Revised Reporting Requirements for Prescriber Identifiers and Other Prescription Drug Event Fields,” we announced that beginning February 28, 2013 we will revise the PDE detail record layout to include the Patient Residence, Pharmacy Service Type, and Submission Clarification Code (SCC) fields. We will require Patient Residence and Pharmacy Service Type to be included on all PDE records with dates of service of February 28, 2013 or later. In those instances when short cycle dispensing is required (that is, for claims where the Patient Residence code is 03- Nursing Facility,) the SCC must be included on the PDE and must be a valid value If the Patient Residence is other than ‘03”, the SCC must be blank. Thus, should an ICF/MR or IMD elect to implement short cycle dispensing, the PDE could not be used to report information on the dispensing methodology used. Should we determine that these facilities are adopting short-cycle dispensing, we will request a future systems change to permit the information to be reported in the PDE. Alabama Alabama Susan Chambers Beverly White Facility Director F aci Iity Director Greil Memorial Psychiatric Hospital Mary Starke Harper Geriatric Psychiatry Center 2140 Upper Wetumpka Road P.O. Box 21231 Montgomery, Alabama 36107 Tuscaloosa, Alabama 35402 Phone: (334) 262-0363 Phone: (205) 759-0929 Fax: (334) 834-4562 Fax: (205) 759-0931 E-mail: [email protected] E-mail: Beverly. [email protected] Alabama Alabama Randy Phillips Beatrice McLean Facility Director Facility Director North Alabama Regional Hospital Searcy Hospital 4218 Highway 31 South PO Box 1090 Decatur, Alabama 35603-5039 Mt. Vemon, Alabama 36560 Phone: (256) 560-220 I Phone: (251) 662-6768 Fax: (256) 560-2203 Fax: (251) 829-5588 E-mail: [email protected] E-mail: [email protected] Alabama Alabama Roxanna Bender Sheila Taylor Director Facility Director Taylor Hardin Secure Medical Facility Bryce Hospital 1301 Jack Warner Pkwy, N.E. 200 University Boulevard Tuscaloosa, Alabama 35404 Tuscaloosa, Alabama 35401 Phone: (205) 556-7060 Phone: (205) 759-0750 Fax: (205) 556-1198 Fax: (205) 759-0890 E-mail: [email protected] E-mail: [email protected] Alabama Alaska Beverly Be/1-Shambley, Ph.D. Ron Adler Director of Ml Facilities CEO Division of Mental Illness Alaska Psychiatric Institute Alabama Department of Mental Health 2800 Providence Drive 100 North Union Street Anchorage, Alaska 99508 P.O. Box 301410 Phone: (907) 269-71 00 Montgomery, Alabama 36130-1410 Fax: (907) 269-7251 Phone: (334) 242-3952 E-mail: [email protected] Fax: (334) 242-0759 E-mail: [email protected] Alaska Arizona li1arianne Holman, Ph.D. C01y Nelson Clinical Director CEO Alaska Psychiatric Institute Arizona State Hospital 2900 Providence Drive Arizona Department of Health Services Anchorage, Alaska 99508 2500 E. Van Buren Phone: (907) 269-7168 Phoenix, Arizona 85034 Fax: (907) 269-7128 Phone: (602) 220-6000 E-mail: [email protected] Fax: E-mail: [email protected] Arkansas Arkansas Steven Henson Jay Hill Facility Administrator Facility Administrator Arkansas State Hospital Arkansas Health Center Department of Human Services, Division of Behavioral Health Services Department of Human Services, Division of Behavioral Health Services 305 South Palm Street 6701 Hwy. 67 Little Rock, Arkansas 72205-5432 Benton, Arkansas 72015 Phone: (501) 686-9826 Phone: (50 I) 860-0526 Fax: (50!) 686-9483 Fax: E-mail: [email protected] E-mail: [email protected] California California Audrey King Linda Persons Acting Executive Director Acting Executive Director Coalinga State Hospital Atascadero State Hospital P.O. Box 5000 10333 El Camino Real Coalinga, Califomia 93210-5000 PO Box 7001 Phone: (559) 935-4303 Atascadero, Califomia 93423 Fax: (559) 935-7118 Phone: (805) 468-200 I E-mail: [email protected] Fax: (805) 468-0103 E-mail: [email protected] California California Cynthia Lusch Dolly Matteucci Acting Executive Director Executive Director Salinas Valley Psychiatric Program Napa State Hospital P.O. Box 1080 2100 Napa Vallejo Highway Soledad, California 93960 Napa, California 94558 Phone: (831) 678-5654 Phone: (707) 253-5454 Fax: (831) 678-5666 Fax: (707) 253-5411 E-mail: [email protected] E-mail: [email protected] California California Jvfichael Barsom Carlos Luna Acting Executive Director Executive Director Metropolitan State Hospital Patton State Hospital 11401 South Bloomfield Avenue 3102 East Highland A venue Norwalk, Califomia 90650 Patton, Califomia 92369 Phone: (562) 651-2245 Phone: (909) 425-7321 Fax: (562) 929-3131 Fax: (909) 425-6169 E-mail: [email protected] E-mail: [email protected] Colorado Colorado Keith LaGrenade. MD. Teresa Bernal, RN Superintendent Interim Superintendent Colorado Mental Health Institute- Fort Logan Mental Health Institute at Pueblo 3520 W. Oxford Ave Colorado Department of Human Services Denver, Colorado 80236 1600 West 24th Street Phone: (303) 866-7094 Pueblo, Colorado 81003 Fax: (303) 866-7088 Phone: (719) 546-4147 E-mail: [email protected] Fax: (719) 546-4484 E-mail: [email protected] Colorado Connecticut Kenneth Cole Jim Pisciotta Director, Mental Health Institute Division CEO Department of Human Services Southwest CT Mental Health System Colorado Department of Human Services 97 Middle Street 3520 West Oxford Avenue, #A-216 Bridgeport, Connecticut 06604 Denver, Colorado 80236 Phone: (203) 579-7368 Phone: (303) 866-7091 Fax: (203) 579-6305 Fax: E-mail: [email protected] E-mail: [email protected] Connecticut Connecticut Helene Vartelas Michael Sernyak, M.D. CEO CEO Connecticut Valley Hospital Connecticut Mental Health Center PO Box 351 P.O. Box 1842 Middletown, Connecticut 06457 34 Park Street Phone: (860) 262-5887 New Haven, Connecticut 06519 Fax: (860) 262-5989 Phone: (203) 974-7144 E-mail: [email protected] Fax: (203) 974-7091 E-mail: [email protected] Delaware Delaware Greg Valentine Kevin Huckshorn, R.N., MS.N., C.A.D.C., I.C.R.C. Chief Executive Officer Director Delaware Psychiatric Center Division of Substance Abuse and Mental Health 1901 N. DuPont Highway Delaware Health and Social Services New Castle, Delaware I 9720 1901 North Dupont Highway Phone: (302) 255-2710 Main Administration Bldg., Room 187 Fax: (302) 255-4422 New Castle, Delaware I 9720 E-mail: [email protected] Phone: (302) 255-9398 Fax: (302) 255-4427 E-mail: [email protected] District of Columbia Florida Dr. Patrick Canavan Bob Quam Chief Executive Officer Hospital Administrator Saint Elizabeths Hospital Treasure Coast Forensic Treatment Facility/ GEO Care, Inc Department of Mental Health 96 Southwest Allapattah Road 2700 Martin Luther King Jr. Avenue, SE Indiantown, Florida 34956 Washington, District of Columbia 20032 Phone: (772) 597-9400 Phone: (202) 299-5500 Fax: (772) 597-9498 Fax: (202) 561-6957 E-mail: [email protected] E-mail: [email protected] Florida Florida Lee Packer Carmen Paroby Hospital Administrator Hospital Administrator So. Florida Evaluation & Treatment Center/ GEO Care, Inc. West Florida Community Care Center 18680 SW 376th Street 5500 Stewart St. Florida City, Florida 33034 Milton, Florida 32570 Phone: (786) 349-600 l Phone: (850) 983-5500 Fax: (786) 349-6082 Fax: (850) 983-5530 E-mail: [email protected] E-mail: [email protected] Florida Florida Joe Infantino Diane James Hospital Administrator Hospital Administrator Northeast Florida State Hospital Florida State Hospital 7487 S. State Road 121 PO Box 1000 Macclenny, Florida 32063 Chattahoochee, Florida 32324 Phone: (904) 259-6211 Phone: (850) 663-7536 Fax: (904) 259-710 I Fax: (850) 663-7303 E-mail: [email protected] E-mail: [email protected] Florida Florida Bill Baxter Diane Funston Hospital Administrator Hospital Administrator No. Florida Evaluation & Treatment Center GEO Care Inc. 1200 NE 55th Blvd. South Florida State Hospital Gainesville, Florida 3260 I 800 East Cypress Drive Phone: (352) 375-8484 Pembroke Pines, Florida 33025 Fax: (352) 264-8305 Phone: (954) 392-3050 E-mail: [email protected] Fax: (954) 392-3499 E-mail: [email protected] Georgia Georgia Nan Lewis Charles Li, M.D.

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