Literature DB >> 18332514

Rejections of drug claims for nursing home residents under Medicare Part D.

Haiden A Huskamp1, David G Stevenson, Nancy L Keating, Joseph P Newhouse.   

Abstract

Some nursing facility administrators and physicians have raised concerns about the increased administrative burden of working across multiple Part D prescription drug plans (PDPs), citing the possibility for adverse resident outcomes and financial burden on facilities when PDPs reject drug claims for residents. We examined data on claims in rejected status for one large long-term care pharmacy as of December 2006. There was considerable variation across PDPs in both rejection rates and reasons for rejection.

Mesh:

Year:  2008        PMID: 18332514      PMCID: PMC2714733          DOI: 10.1377/hlthaff.27.2.560

Source DB:  PubMed          Journal:  Health Aff (Millwood)        ISSN: 0278-2715            Impact factor:   6.301


  3 in total

1.  Prescription drugs in nursing homes: managing costs and quality in a complex environment.

Authors:  Dan Mendelson; Rajeev Ramchand; Richard Abramson; Anne Tumlinson
Journal:  NHPF Issue Brief       Date:  2002-11-12

2.  Medicare Part D and nursing home residents.

Authors:  David G Stevenson; Haiden A Huskamp; Nancy L Keating; Joseph P Newhouse
Journal:  J Am Geriatr Soc       Date:  2007-07       Impact factor: 5.562

3.  Diagnosis-based risk adjustment for medicare prescription drug plan payments.

Authors:  John Robst; Jesse M Levy; Melvin J Ingber
Journal:  Health Care Financ Rev       Date:  2007
  3 in total
  5 in total

1.  Fixing flaws in Medicare drug coverage that prompt insurers to avoid low-income patients.

Authors:  John Hsu; Vicki Fung; Jie Huang; Mary Price; Richard Brand; Rita Hui; Bruce Fireman; William H Dow; John Bertko; Joseph P Newhouse
Journal:  Health Aff (Millwood)       Date:  2010-10-28       Impact factor: 6.301

Review 2.  Medicare part D and long-term care: a systematic review of quantitative and qualitative evidence.

Authors:  Camilla B Pimentel; Kate L Lapane; Becky A Briesacher
Journal:  Drugs Aging       Date:  2013-09       Impact factor: 3.923

3.  Effect of Part D coverage restrictions for antidepressants, antipsychotics, and cholinesterase inhibitors on related nursing home resident outcomes.

Authors:  David G Stevenson; A James O'Malley; Stacie B Dusetzina; Susan L Mitchell; Barbara J Zarowitz; Michael E Chernew; Joseph P Newhouse; Haiden A Huskamp
Journal:  J Am Geriatr Soc       Date:  2014-08-14       Impact factor: 5.562

4.  Nursing home residents and enrollment in Medicare Part D.

Authors:  Becky A Briesacher; Stephen B Soumerai; Terry S Field; Hassan Fouayzi; Jerry H Gurwitz
Journal:  J Am Geriatr Soc       Date:  2009-08-21       Impact factor: 5.562

5.  Medicare Part D claims rejections for nursing home residents, 2006 to 2010.

Authors:  David G Stevenson; Laura M Keohane; Susan L Mitchell; Barbara J Zarowitz; Haiden A Huskamp
Journal:  Am J Manag Care       Date:  2012-10       Impact factor: 2.229

  5 in total

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