Wolters Kluwer Health, a global provider of information for healthcare professionals and students, has released the Medi-Span® Medicare Plans File, which provides indicators to designate coverage under Medicare Part B and/or Part D, along with additional attributes to further support or clarify a drug's coverage under these programs. As a valuable tool for Pharmacy Benefit Managers and insurance payers, this file will help to facilitate processes and policies around drugs covered by Medicare Part B and Part D.
Pharmacy Benefit Managers (PBM) and payers create processes and policies for medications that fall under Medicare Part B (e.g., prescription medications administered in a physician's office) and/or Part D (i.e., outpatient prescriptions filled by a pharmacy) drug coverage. However, there is no single data source or solution available in the market today that provides all of the indicators and associated information for medications covered under these programs, requiring users to utilize more than one file/source to define coverage.
The Medicare Plans File is the first to provide indicators, attributes, and supporting comment text that assists in identifying drugs that are eligible for Medicare Part B and/or Part D reimbursement.
