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The Health Professional's Role in Formulary Management of Medicare Part D Benefits
Please read through the following information and click continue.

ACPE Universal Program Number: 207-000-06-090-H04
Release Date: May 5, 2006
Expiration Date: May 5, 2009


Starting January 1, 2006, pharmacists began to experience a multitude of new challenges associated with the new Medicare prescription drug benefit. One of the most time-consuming challenges in the program will be formulary management. Prior authorization requirements, step therapy protocols, and tight formularies could become a frustrating way of life for many community pharmacies and the patients they serve. It is estimated that most Medicare beneficiaries will encounter new formulary requirements. Many of these patients, especially those transitioning from the open formularies of the Medicare drug discount cards and Medicaid, will need to change their existing therapy to cover Part D drugs. This transition could be a nightmare for unprepared pharmacists. During this transition phase, pharmacists will be in the crucial position of interacting between the plan, prescriber and patient to lessen any delays in drug coverage. Preparation will be key for pharmacists to minimize the economic and humanitarian impact of confused beneficiaries and to limit any delays in care due to this new program.

Learning Objectives
Upon successful completion of this activity, the pharmacist should be better able to:

  1. List the three (3) operating principles of the formulary system.
  2. Define the role of the plan pharmacy and therapeutics (P&T) committee in the formulary management process.
  3. Identify four (4) drug benefit management components that interface operationally with a plan formulary.
  4. Identify the six (6) therapeutic categories of drugs for which CMS requires that virtually all available agents be included in the formulary as a covered benefit.
  5. List five (5) therapeutic categories of drugs that are expressly excluded from formulary inclusion and coverage under Medicare Part D.

Target Audience
The target audience is physicians, pharmacists, and case managers working with the Medicare Part D Formularies, especially those working in managed care.

Instructions for Participation
To receive a certificate of completion that indicates your eligibility for continuing education credit, you must:

  • Review the content of the activity.
  • Successfully complete the post-test (70% or higher).
  • You will have two (2) opportunities to successfully complete the activity.

Your statement of credit will be issued immediately upon successful completion of the post-test and submission of the evaluation.

There is no fee for this activity.


Accreditation expired effective 5/4/2007
Creative Educational Concepts, Inc. is accredited by the Accreditation Council of Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Creative Educational Concepts, Inc. designates this educational activity for a maximum of 2.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

ACPE logoThe National Community Pharmacists Association (NCPA) is approved by the Accrediation Council for Pharmacy Education as a provider of continuing pharmacy education. This program will provide 2.0 contact hours (.20 CEUs) of continuing pharmacy education credit under the number 207-000-06-090-H04.

Case Managers

Accreditation expired effective 5/4/2007
This activity has been approved by the Commission for Case Manager Certification Approval #7230251886 through 5/4/07 for up to 2.0 clock hours of continuing education credit.

Timothy Covington, MS, PharmD (Click on faculty name to view biography)
Bruno Professor of Pharmacy
McWhorter School of Pharmacy
Samford University
Birmingham, Alabama

Disclosure Declaration
It is the policy of Creative Educational Concepts, Inc. (CEC) and National Community Pharmacists Association (NCPA) to ensure independence, balance, objectivity, scientific rigor, and integrity in all of their continuing education activities.

The author, sponsor, and publisher of this continuing education activity have made all reasonable efforts to ensure that information contained herein is accurate in accordance with the latest available scientific knowledge at the time of accreditation of this continuing education program. Information regarding drugs (e.g., their administration, dosages, contraindications, adverse reactions, interactions, special warnings, precautions) and drug delivery systems are subject to change, however, and the reader is advised to check the manufacturer's package insert for information concerning recommended dosage and potential problems or cautions prior to dispensing or administering the drug or using the drug delivery systems.

Approval of credit for this continuing education activity does not imply endorsement by CEC and NCPA of any product or manufacturer identified.

Any medications or treatment methods suggested in this CE activity should not be used by the practitioner without evaluation of their patient's condition(s) and possible contraindication(s) or danger(s) of use of any specific medication.

Faculty Disclosure Statement
Dr. Covington has disclosed that he has no actual or potential conflcits of interest in relation to this activity.

Commercial Support
Boehringer Ingelheim Pharmaceuticals, Inc. logoThis activity is supported by an educational grant from Boehringer Ingelheim Pharmaceuticals, Inc.

Software Requirements
Windows 2000
Internet Explorer 5.5 or Firefox
*Adobe Acrobat Reader

Mac OS 10.2.8

*Adobe Acrobat Reader






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