MEDICARE PART D

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MEDICARE PART D

• Update on FQHC Outreach

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At Fort Bend Family Health Center

• Our missions is to make it easier for Medicare
  beneficiaries to understand their new
  prescription drug coverage and how to use its
  benefits most effectively.

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Medicare Patient Population

• 5 of clinic patients
• 10 of our pharmacy volume
• - One-third are dual-eligible
• - Other rely on programs like Share the Care and
  patient assistance to afford their medications

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Patient Education

• Flyers/Posters
• Fact Sheets
• Sample of Mailings
• Planned Events
• Pharmacy Month
• Senior Day
• Representative from participating plan

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Pharmacy Staff Education

• Change in payment of Medicaid pharmacy benefits
  for dual eligible beneficiaries.
• Third Party Claims
• Software changes
• Co-pays
• Formularies

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Clinic Staff Education

• Identify key staff
• (Nurses, registrars, social workers, front desk)
• Education through staff meeting and newsletters
  on program basics and important dates.

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Our Role

• Provide information
• Help them understand program basics
• Assist with enrollment

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Outreach Methods

• Recognition of Pharmacy Month October05
• - Large banner to attract attention
• - Know Your Medicine pharmacy tips
• - Provided Medicare Part D information
• focus on important dates and what to look out
  for in the mail.

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Outreach Methods

• Senior Health Day event November05
• Provided immunizations
• Free diabetic supplies
• Health information
• Medicare Part D presentation and information

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Lessons Learned

• Get total organization commitment
• Identify dedicated person(s) to oversee project
• Build partnerships with local organizations
• Collective training efforts from different
  departments

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Lessons Learned cont..

• Plan several presentations to reach larger number
  of people
• Adequate staff to provide one-on-one assistance
• Be prepared to deal with literacy and language
  barriers
• Follow up

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Useful Resources

• Outreach and Enrollment in the LIS Determining
  What Works for Your Organization
• www.accesstobenefits.org
• Lessons from the Field Best Practices to
  Educate and Outreach to seniors on the Medicare
  Prescription Drug Program
• drafted by NACHC www.nachc.org

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Pharmacy Part D Enrollment

• Request and review of Part D contracts
• - profitability and use of 340B pricing
• Use of the HRSA Safety Net addendum
• Decided the go with who TACH negotiated contracts
  with
• - Community Care RX

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Dual Eligible Issues

• Will we take their plans?
• How will it work. Copays?
• How to get uncovered drugs?
• Change in pharmacy services.

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Pharmacy Staff Patient Interaction

• Performed eligibility check through software
  system
• Informed patient of plan they were enrolled
• dual-eligibles have the the option of
  switching
• Continued education on choosing a plan.
• Focus on cost, coverage and convenience

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Pharmacy Staff Patient Interaction

• Use of online Medicare plan tools
• Screen patients for low-income subsidy
  eligibility and assistance with application
• Assist with Community Care plan enrollment

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Impact on Pharmacy and Clinic

• Transfer of prescription of patient who dont
  have Community Care
• Loss of clientele and revenue
• Ongoing task

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Useful Websites

• www.medicare.gov
• www.ssa.gov
• www.medicareadvocacy.org
• www.accesstobenefits.org
• www.cms.hhs.gov
• www.nachc.com