Increase in Rejected Prescription Claims Driven by Medicare Part D
New data reveal 24% increase in rejected prescriptions during program’s first quarter
PHOENIX, May 18, 2006 – Wolters Kluwer Health, a global provider of drug and medical information services and content to the healthcare and pharmaceutical industries, today provided an analysis of recent Medicare Part D prescription data that shows a substantial rise in the number of rejected prescription claims. These rejected prescription claims may be preventing many program enrollees from getting their medications in a timely manner.
Rejected prescription claims are those refused for payment by their insurance company or third-party payer and the prescription is not dispensed to the patient. According to the findings, the total number of rejected claims grew by 24% from the fourth quarter of 2005 to the first quarter of 2006, with Medicare Part D accounting for a significant portion of those rejected prescription claims.
Using Source® Dynamic Claims™, the industry’s only real-time analysis tool for claims data, Wolters Kluwer Health has identified the initial impacts of Medicare Part D on patients during this first quarter. The public-domain whitepaper, which reviews claim rejections, approvals and reversals, was posted today on the company’s website at www.wkhealth.com.
“Through the eyes of Dynamic Claims, we knew there’d may be a higher volume of claims during the new program’s first quarter but we never anticipated such a large increase in the number of rejections,” said Michael Weintraub, EVP & GM, Healthcare Analytics, Pharma Solutions business unit, Wolters Kluwer Health.
Approximately 28 million people elected to enroll in one of the available Medicare Part D plans by the end of the first quarter 2006, dramatically under the original 39.1 million estimate published in the Federal Register as part of the final regulations implementing the Part D program in January 2005 , but in line with the revised estimate of 28 to 30 million released at the end of 2005 . The initial enrollment period for 2006 ended on May 15, 2006, after which Medicare Part D beneficiaries will have to pay a financial penalty for late enrollment.
“We expect that Q2 may reveal the results that most would expect in terms of more enrollees and better prescription drug coverage for those who need it,” added Weintraub.”
For more information about Source Dynamic Claims and other Source products or to view the full whitepaper, visit www.wkhealth.com.
About Dynamic Claims
The Source Dynamic Claims database contains claims-based information from over 24,100 U.S. retail pharmacies, giving a unique, real-time perspective of the essential elements in healthcare prescription activity.
About Wolters Kluwer Health
Wolters Kluwer Health (Conshohocken, Pa.) is a leading provider of information for professionals and students in medicine, nursing, allied health, pharmacy and the pharmaceutical industry. Major brands include Lippincott Williams & Wilkins and Facts & Comparisons for medical and drug reference tools and textbooks; Ovid Technologies, Medi-Span and ProVation Medical for electronic information; and Adis International and Source® for pharmaceutical information.
Wolters Kluwer is a leading multinational publisher and information services company. The Company's core markets are health, corporate services, financial services, tax, accounting, legal, regulation, and education. Wolters Kluwer has annual revenues (2005) of €3.4 billion, employs approximately 18,400 people worldwide and maintains operations across Europe, North America and Asia Pacific. Wolters Kluwer is headquartered in Amsterdam, the Netherlands. Its depositary receipts of shares are quoted on the Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. For more information, see www.wolterskluwer.com.
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