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Good News from the Government for OCLI Doctors and their Patients
July 6, 2010
Medicare Patients Now Allowed To Refill Ophthalmic Medications Early
Ophthalmic Consultants of Long Island (OCLI) is pleased to announce that their Medicare patients will no longer have the problem of being denied refilling their prescriptions too early at the pharmacy. The Centers for Medicare and Medicaid Services (CMS) received numerous complaints regarding early refills to ophthalmic topical products and have made changes to their “refill too soon” policy. CMS recognized that the early refill edits are an important utilization tool used to promote compliance and prevent waste. It will also reduce putting patients at risk due to interruptions in drug therapy that could potentially have serious consequences. “This is a very important breakthrough for our patients on chronic topical therapy, particularly glaucoma drops” said Dr. Stanley Berke, a partner of OCLI who practices in their Lynbrook office. The new guidance pertains to all Part D plan sponsors and CMS recommends that sponsors allow the following for topical ophthalmic products:
• Permit refills at 70% of the predicted days of use. By way of an example, for a prescribed medication with an expected duration of 30 days of use, the refills would be permitted at day 21.
• Ensure that the refill allowances are the same regardless of purchase through retail or mail-order sources.
• Permit physicians to authorize earlier refills than 70% days of use for particular beneficiaries who continue to have difficulty with inadvertent wastage.
For more information, please call 1-866-733-6254 or visit www.ocli.net.
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