Which drugs will fall under the 14-day supply rules in nursing homes and will I have to pay multiple copays?

Your Medicare plan coverage · published Sep 16, 2013

First a bit of history, under Section 3310 of the Affordable Care Act of 2010, CMS will require 14-day-or-less dispensing specifically for solid oral doses of brand name drugs. CMS will not require the 14-day supply on dispursements for ‘‘acute illnesses’’ and ‘‘drugs difficult to dispense.’’ Antibiotics and drugs that must be dispensed in their original container as indicated in the Food and Drug Administration Prescribing Information and drugs that are customarily dispensed in their original packaging to assist patients with compliance (for example, oral contraceptives) will be excluded from the requirement. CMS believes that with this simplification of the rule, a list of Part D drugs by NDC is not necessary.

As to copayments, you will only pay the equivalent of one 30-day supply's cost-sharing (copayment or coinsurance). The regulation states: "Copayment may be collected at the first dispensing event in a month, the last dispensing event in a month, or prorated based on the number of days a Part D drug was dispensed in a month." This excerpt is found on page 31 of the regulation, middle column, half-way down the page. (See: https://www.ascp.com/sites/default/files/ASCP-FinalRule-ChangesPartC-D-041511.pdf).

Here is a good article by the ASCP: https://www.ascp.com/articles/short-cycle-14-day-or-less-dispensing-practice-resource-center