Some nursing facility administrators and physicians have raisedconcerns about the increased administrative burden of workingacross multiple Part D prescription drug plans (PDPs), citingthe possibility for adverse resident outcomes and financialburden on facilities when PDPs reject drug claims for residents.We examined data on claims in rejected status for one largelong-term care pharmacy as of December 2006. There was considerablevariation across PDPs in both rejection rates and reasons forrejection.