PDP sponsor and MA organization responsibilities
Each PDP sponsor offering a prescription drug plan or MA organization offering an MA–PD plan—
(aa)#
may not limit the option for an enrollee to make such an election to certain covered part D drugs;
(bb)#
shall, prior to the plan year, notify prospective enrollees of the option to make such an election in promotional materials;
(cc)#
shall include information on such option in enrollee educational materials;
(dd)#
shall have in place a mechanism to notify a pharmacy during the plan year when an enrollee incurs out-of-pocket costs with respect to covered part D drugs that make it likely the enrollee may benefit from making such an election;
(ee)#
shall provide that a pharmacy, after receiving a notification described in item (dd) with respect to an enrollee, informs the enrollee of such notification;
(ff)#
shall ensure that such an election by an enrollee has no effect on the amount paid to pharmacies (or the timing of such payments) with respect to covered part D drugs dispensed to the enrollee; and
(gg)#
shall have in place a financial reconciliation process to correct inaccuracies in payments made by an enrollee under this subparagraph with respect to covered part D drugs during the plan year.