PAAS National® analysts frequently see PBM audit results where auditors have flagged claims with ‘incorrect DAW code submitted’ – while these are often educational discrepancies, it is important to understand the implications of incorrect DAW code submission and develop a consistent process for pharmacy staff to follow.
For the second time in the last three years, numerous pharmacies have received, what PAAS National® would consider extortionary, letters from LifeScan.
Pharmacies continue to see a large number of prescriptions for GLP-1 medications like Ozempic and Mounjaro and have concerns about the risk of PBM audits and recoupments.
PAAS National® frequently gets questions about whether pharmacies may substitute various medications and if such substitutions require the approval of the prescriber.
PAAS National® frequently gets questions about whether pharmacies may substitute various medications and if such substitutions require the approval of the prescriber.
Caremark issued a Pharmacy Update memo on March 8, 2023, stating that they would resume signature log requirements for audits effective May 12, 2023.
All PBMs update their Provider Manuals at regular intervals and Express Scripts (ESI) is no exception.
As most of you (and your Medicare patients) have undoubtedly noticed, Medicare has applied a $35 per month cap on copays for insulin prescriptions ($105 for a 3-month supply) for years 2023-2025.
Many pharmacies continue to receive new prescriptions from patients eager to start on therapy for Ozempic and Mounjaro.
Caremark has released the 2022 CVS Caremark Provider Manual Supplement which is effective January 1, 2023.
