US · guidance
CMS Pub. 100-18, ch. 6, § 30.2.3
Long-term Care Accessibility
Part D sponsors will be required to provide medically necessary prescription drug treatments for
enrollees in the general Medicare population, as well as those enrollees who reside in LTC
facilities. For example, it is CMS’ expectation that sponsors provide coverage of dosage forms
of drugs that are widely utilized in the LTC setting, such as unit dose products and liquid,
chewable, and parenteral preparations. Further, while nebulized solutions may not be required
on all formularies, CMS would expect sponsors to also cover these dosage forms under
circumstances in which Part B coverage is not available. When determining days supplies for
residents in LTC facilities, Part D sponsors should follow industry best practices and allow for at
least 31 days per fill.
History
(Rev. 2, Issued: 07-18-08; Effective/Implementation Date: 07-18-08)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-09-17
- Edition
- iom-2026-09-17
- Content hash
921ef4e54058fe5b03d096dddaae037d6090602034c0b873a35f1f5d78dec465
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