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Medicare part D exclusions

This article was originally published in The Tan Sheet

Executive Summary

"Medical foods such as enteral nutrients" are not regulated as drugs and therefore will not be covered by the Medicare Part D drug benefit, the Centers for Medicare & Medicaid Services says in a July 27 draft document. The prescription drug benefit, which allows Medicare recipients to receive drug coverage under the Medicare Modernization Act of 2003, becomes effective Jan. 1, 2006. In order to be included with the Part D benefit, a drug "generally must be regulated by the FDA as a drug, biological or vaccine," CMS explains. "Prescription vitamins and mineral products, except prenatal vitamins and fluoride preparations" may also be excluded from Part D coverage, according to the document. However, plan sponsors can "generally" include them as part of supplemental benefits...

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