05/29/2026
New guidance released: NCPDP issued updated FAQ guidance for Medicare GLP-1 Bridge claims.
When pharmacies should use the Bridge:
If a prescriber explicitly instructs them to submit to the GLP-1 Bridge
If a Medicare Part D claim is denied, potentially making the patient eligible.
Denial communication: Pharmacies may learn about Part D denials via the prescriber, patient, or claim response.
Submission details: Specific messaging and payer information (e.g., BIN/PCN) should be included when resubmitting claims to the Bridge.