Ozempic and Mounjaro Prescriptions – Between a Rock and a Hard Place
Many pharmacies continue to receive new prescriptions from patients eager to start on therapy for Ozempic and Mounjaro.
Entries by Eric Hartkopf, PharmD
2022 CVS Caremark Provider Manual Supplement for 2023
Caremark has released the 2022 CVS Caremark Provider Manual Supplement which is effective January 1, 2023.
Essential Elements of Corrective Action Plans
PAAS National® analysts have recently seen an increased number of PBM audits with “significant” results, including a large number of unique issues, large dollar amounts (>$100,000) or both. Audits of this magnitude may trigger further consequences such as additional audits, payment suspension and/or threat of network termination.
Medicare Extends Part B Coverage for Kidney Transplant Drugs
Patients with Medicare because of End-Stage Renal Disease (ESRD) currently lose coverage 36 months after a kidney transplant unless otherwise eligible for Medicare.
Caremark Bulk Purchase Requirements
As 2022 comes to a close, we know that many pharmacies will make “bulk purchases” ahead of the new year in anticipation of price increases or to obtain wholesaler rebates.
Authorized Distributors of OTC Diabetic Test Devices
Most pharmacies are familiar with the basic requirements of the Drug Supply Chain Security Act (DSCSA), including the requirement to purchase prescription products from authorized suppliers.
MounjaroTM Off-Label Use for Weight Loss Spells T-R-O-U-B-L-E
PAAS National® analysts have received many phone calls regarding prescriptions for MounjaroTM – in most cases the medication is suspected of being used “off-label” for weight loss.
Caremark Cease and Desist Letters – Trudhesa®
PAAS National® analysts have recently assisted a few pharmacies that received “Cease and Desist” Letters from Caremark related to dispensing Trudhesa® nasal spray for migraines.
Medicare Part D Long-Term Institutionalized (LTI) Resident Report
PAAS National® recently assisted numerous pharmacies that received an email communication from Express Scripts stating the pharmacy had inappropriately billed Part D claims while patients were in a qualified Part A stay.
Automatic Mailing for Part D Patients
Reminder tp pharmacies on some specific requirements when automatically mailing refills to Medicare Part D patients.
