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Anyone have a case yet? Just received my first inquiry. The client has the requisite exception diagnosis. Without any firm public notices I have found, it would appear that the normal formulary exception process would be the starter. The last word on the cardiac exception was that it would start sometime. As of today no PDP's (or MAPD's) on Medicare.gov indicate it's in their formulary--and if it does show up, it will create a mess unless it's somehow specified as diagnosis related only, and of course, prior authorization.
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