Entries by Erin McDonald, PharmD

Will Your Signature Logs Pass an Audit?

Since the beginning of the new year, PAAS National®® has seen a 14% increase in audits from third-party payors (18% for onsite audits)! When collecting the requested documents for an audit, signature logs are commonplace. Invariably, the one patient who refuses to sign their name (or uses a smiley face instead) to confirm receipt of their […]

Keeping the Diagnoses Straight for GLP-1 Products

The FDA recently announced that Zepbound® (tirzepatide) has been approved for the treatment of moderate to severe obstructive sleep apnea (OSA) in adults with obesity. This is the first GLP-1 indicated for OSA. The popularity of GLP-1 products has not slowed down, but with the new diagnosis for Zepbound® it is a good time to […]

Billing Ozempic® 0.25 mg Weekly as Maintenance – What PBMs Say

PAAS National®® continues to see GLP-1 medications as a high audit target. Recall the FDA-approved initial dosing for Ozempic® is 0.25 mg injected subcutaneously once weekly for four weeks, followed by 0.5 mg once weekly (see section 2.2 of product labeling). However, pharmacies often see prescribers write for Ozempic® 0.25 mg weekly dose as maintenance. […]