1. States with Mail-Order Requirement, 2003
Rizzo, Fox, Trail, and Crystal, State Pharmacy Assistance Programs: A Chartbook—Updated and Revised, January 2007
States with Mail-Order Requirement, 2003
Private plans administering the Medicare Part D benefit are permitted to offer a home delivery option via a mail-order pharmacy but can only offer this in addition to the retail pharmacies in a plan’s network that must meet a minimum access standard. Draft Part D regulations also allowed PDPs to vary cost-sharing by preferred and non-preferred pharmacies, which may include mail-order pharmacies.
Only Massachusetts and Nevada encouraged their participants to use mail-order by offering a lower copayment than would be available at the retail pharmacy (i.e., the copayment for a three-month mail-order supply is equal to that of a two-month supply from a pharmacy).
In its FY 2004 Appropriation Act, the New Jersey legislature allowed the state to issue an RFP for a voluntary mail-order service, but implementation was delayed because the state focused its attention on coordinating with the Medicare interim discount card program, which includes mail-order and could conflict with the state initiative.
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