Question

Under what conditions can a Medicare prescription drug plan reduce its coverage for a given drug during the first 60 days of the year?

Choose one answer.
a. If the Medicare prescription drug plan can show that reducing coverage early in the year will result in savings for the Part D plan and the Medicare program, generally the plan may make such a change.
b. When the Part D plan can demonstrate to CMS that no enrollee has accessed the medication in the past six months, generally the plan can remove the drug from its formulary within the first 60 days of the year.
c. When a formulary change is in response to a drug's removal from the market.
d. Under no conditions can a Medicare Part D prescription drug plan reduce its coverage for a given drug at any point during the year.

Answer 1

A Medicare prescription drug plan can reduce its coverage for a given drug during the first 60 days of the year if it can demonstrate that the change will result in savings for the plan and the Medicare program.

Step-by-step explanation:

A Medicare prescription drug plan can reduce its coverage for a given drug during the first 60 days of the year under certain conditions. The correct answer is a. If the Medicare prescription drug plan can show that reducing coverage early in the year will result in savings for the Part D plan and the Medicare program, generally the plan may make such a change.