Proper Billing for Intermittent Use Medications
Calculating proper days’ supply on continuous use medications can be hard enough; how do PBMs and auditors view medications that are used intermittently?
Independent pharmacy is in my blood. Both my great-grandfather and grandfather owned Rexall stores in northern Wisconsin. I always had the dream of owning my own independent pharmacy (with my very own soda fountain!), but I have quickly found being part of your independent pharmacy’s success story is even more rewarding for me. I look forward to being part of the trusted PAAS team that helps you navigate the waters of the ever-changing world of pharmacy audits and Fraud, Waste, and Abuse regulations.
Calculating proper days’ supply on continuous use medications can be hard enough; how do PBMs and auditors view medications that are used intermittently?
PAAS continues to see members receiving emails from Express Scripts (ESI) requesting pharmacies to …
When you are preparing for an audit, a PAAS National® analyst has likely told you to ensure a prescriber’s Drug Addiction Treatment Act (DATA) 2000 Waiver ID, or XDEA number, is included on prescriptions for medications used to treat opioid use disorder along with their regular DEA number.
Pharmacies have begun to see more prescriptions for Natesto® (testosterone) nasal gel.
For various reasons, including ingredient shortages or manufacturer back orders, a pharmacist may be required to compound a commercially available product.
Express Scripts sent a memo to network providers the middle of October, pertaining to copayment collection, to ensure requirements are being met in the appropriate manner.
Consider a scenario where your pharmacy has been dispensing a product for years and you find that the product is being discontinued, requiring a product substitution.
This month marks two years since the U.S. Food and Drug Administration (FDA) clarified their intentions behind revising insulin pen labeling, yet insulin pen boxes continue to present issues to pharmacies trying to establish best practices surrounding its dispensing and billing.
The U.S. Department of Health and Human Services (HHS) has proposed to strengthen the interpretation of the Section 1557 of the Affordable Care Act (ACA) last modified in 2020 (“2020 Rule”).
With the overturning of Roe v. Wade, the U.S. Supreme Court ruling on an individual’s rights surrounding abortion, pharmacies may be left wondering how to proceed.
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