Medicare Issues New Guidance on Consent Policy for Part D Prescriptions

The Centers for Medicare & Medicaid Services has updated its policy on obtaining patient consent for automatic shipments for home delivery of Medicare Part D prescriptions. The following requirements apply to new or renewal prescriptions submitted by prescribers to the Express Scripts Home Delivery Pharmacy.

  • First-time home delivery users — Patient consent is required if the individual has no history of prescriptions with the home delivery pharmacy.
  • Current or past home delivery users — Patient consent is required if the individual has no history of prescriptions with the home delivery pharmacy within the past 12 months. (Consent is not required if an enrollee has used home delivery within the past 12 months.)

If required, the Medicare Part D prescription will not be filled until patient consent is obtained. Medicare enrollees can proactively provide consent by accessing their online account at www.express-scripts.com or calling Express Scripts toll-free at 888‑416‑3326.