November 15th, the first day of open enrollment in the new Medicare Part D program, is being referred to as “Part D Day” by many industry experts. Like the famous D Day of World War II, it is filled with many uncertainties for many of the key players.

Although the federal government has been rushing to award contracts for Part D sponsors, it has issued few clear guidelines on how they will be allowed to market the new benefit. In addition, many industry analysts are concerned CMS (Center for Medicare and Medicaid Services) implementation plans are behind schedule and that it will not be ready for Jan. 1, 2006, the first day the new benefit goes into effect and members are able to obtain drugs through it.

Many public and private officials continue to scrutinize every single program detail, and CMS continues to respond to and manage these questions and concerns at an impressive pace.

Insurance industry experts are closely watching the number of people the government will be auto-enrolling. Current plans call for CMS to auto-enroll low-income Medicare beneficiaries and “dual-eligibles” (Medicare and Medicaid).

According to Drug Benefit News, current projections are 14.3 million beneficiaries will be enrolled in the new Medicare Prescription Drug Plan (PDPs) in 2006. Of those, 10.6 million are projected to come in through facilitated or automatic enrollment. The remaining 3.7 million projected members will join as purchasers of Medicare supplemental plans.

On September 23, CMS announced the names of organizations approved to offer prescription drug benefits under Medicare Part D. Three of the 10 nationwide PDP sponsors are PBMs: Medco Health Solutions, Caremark Rx and PBM MemberHealth. The other nationwide PDP sponsors are large health plans including Aetna, CIGNA, PacifiCare and Unicare (owned by Wellpoint).

Although the large PBMs say they are not out to directly compete with the large health plans in attracting members, their approval as nationwide sponsors could give them an advantage as they will be scheduled to receive a significant number of auto-enrollees.

As of mid-October, CMS had awarded 320 separate Medicare Advantage (MA) contracts.