§423.906. General payment provisions.
42 C.F.R. § 423.906
Regular Federal matching. Regular Federal matching applies to the eligibility determination and notification activities specified in § 423.904(a) and (b).
Medicare as primary payer. Medicare is the primary payer for covered drugs for Part D eligible individuals. Medical assistance is not available to full-benefit dual eligible individuals, including those not enrolled in a Part D plan, for—
Part D drugs; or
Any cost-sharing obligations under Part D relating to Part D drugs.
The effective date of paragraphs (b)(1) and (b)(2) of this section is January 1, 2006.
Noncovered drugs. States may elect to provide coverage for outpatient drugs other than Part D drugs in the same manner as provided for non-full benefit dual eligible individuals or through an arrangement with a prescription drug plan or a MA-PD plan.
Notes, amendments, and revision history
Amendments
[70 FR 4525, Jan. 28, 2005, as amended at 73 FR 20509, Apr. 15, 2008]
Authority
Authority: 42 U.S.C. 1302, 1306, 1395w-101 through 1395w-152, and 1395hh.
Source
Source: 70 FR 4525, Jan. 28, 2005, unless otherwise noted.
Amendments
[70 FR 4525, Jan. 28, 2005, as amended at 73 FR 20509, Apr. 15, 2008]