Indicates Whether Part D Plan Covers Excluded Drugs

SAS Name
EXCLUDED_DRUGS

This variable indicates whether any excluded drugs are part of the Part D plan's supplemental coverage (e.g., benzodiazepines, barbiturates).

Comments

This variable applies to Enhanced Alternative Plans ONLY.

If EXCLUDED_DRUGS='Y' then the FORMULARY_ID for this plan will have entries in the excluded drug file in the Formulary Characteristics File. However, there may be other plans with the same FORMULARY_ID that do not cover excluded drugs (these are distinguished by the CONTRACT_ID, PLAN_ID and FORMULARY_ID).

The CCW constructs the Plan Characteristics File from information submitted by plan sponsors to CMS’s Health Plan Management System (HPMS).

Employer and National Program of All-inclusive Care for the Elderly (PACE) plans are waived from reporting Plan Benefit Package information.

For those plans that did not report, the value of this variable will be blank.

Source: CMS (HPMS Files)

Code Code value
Y Yes
N No
9 Not Applicable