The Medicare Prescription Drug Modernization and Improvement Act of 2003 (MMA) provides for a prescription drug benefit under Medicare (Part D) that became effective on January 1, 2006. The MMA requires persons who are dually eligible for Medicaid (Title XIX or Title XXI) and Medicare (Title XVIII) to receive available prescription drugs from Medicare Prescription Drug Plans (PDPs) or Medicare Advantage Prescription Drug Plans (MA-PDs). This legislation impacts Arizona's public behavioral health system, as Medicaid no longer covers the prescription drug costs (on drugs that are available through Medicare) for behavioral health recipients who are dually eligible.

The resources found on this page are meant to provide T/RBHAs, behavioral health providers, advocacy groups and behavioral health recipients with easy access to informational and educational resources on the MMA.

MMA Legislation:

• Final Rules, Medicare Prescription Drug Benefit (PDF)
• Final Rules, Medicare Advantage Program (PDF)

ADHS/DBHS requirements regarding Medicare Part D:

• ADHS/DBHS Provider Manual Section 3.1 (PDF)
• ADHS/DBHS Provider Manual Section 3.21 (PDF)
• ADHS/DBHS Provider Manual Section 7.2 (PDF)
• Policy Clarification: Medicare Part D (PDF)
• 12/9/05 Decision Letter to the T/RBHAs (PDF)
• 10/19/05 Decision Letter to the T/RBHAs (PDF)

Medicare Part D Costs:

• Medicare Part D Benefits and Costs (PDF)

General Resources:

• CMS Medicare Webpage
• Social Security Administration (SSA) Medicare Modernization Act Webpage
• Mental Health Part D Webpage
• AHCCCS Medicare Modernization Act Webpage

Who to Contact:

§         CMS Part D Issues Reporting Form (PDF)

§         Part D Regional Office Contacts

§         Medicare Part D Enrollment and Limited Income Subsidy Contact List (PDF)

§         Federal and State Agency and T/RBHA Contacts for MMA Information

CMS Webtools:

Formulary Finder for Prescription Drug Plans

Medicare Prescription Drug Plan Finder

Medicare Prescription Drug Plan Finder Demonstration

The Social Security Administration (SSA):

§         Limited Income Subsidy Program (Extra Help):  http://www.ssa.gov/organizations/medicareoutreach2/
 

§         Notice and Application for Extra Help:  https://s044a90.ssa.gov/apps6z/i1020/main.html
 

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