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Stevenson DG, Keohane LM, Mitchell SL, Zarowitz BJ, Huskamp HA. Medicare Part D claims rejections for nursing home residents, 2006 to 2010. The American journal of managed care. 2012 Oct;18(18). 647-54. NIHMSID: NIHMS431339.
Abstract
Much has been written about trends in Medicare Part D formulary design and consumers' choice of plans, but little is known about the magnitude of claims rejections or their clinical and administrative implications. Our objective was to study the overall rate at which Part D claims are rejected, whether these rates differ across plans, drugs, and medication classes, and how these rejection rates and reasons have evolved over time.