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?
Entries by Meredith Thiede, PharmD
Express Scripts Validating 340B Claim Eligibility
PAAS continues to see members receiving emails from Express Scripts (ESI) requesting pharmacies to …
XDEA Numbers Have Been NiXed…but Not the Training
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.
Natesto® Nasal Gel Pump – Bill It Right!
Pharmacies have begun to see more prescriptions for Natesto® (testosterone) nasal gel.
FDA’s Guidance on Compounding Commercially Available Products in Short Supply
For various reasons, including ingredient shortages or manufacturer back orders, a pharmacist may be required to compound a commercially available product.
Express Scripts Reminds Pharmacies of Copay Collection Obligations
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.
Product Substitution Best Practices
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.
Breaking Insulin Pen Boxes: Where Are We Now?
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.
Proposed Section 1557 Rule – How Could It Affect You?
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”).
Navigating Rights & Responsibilities in a Post-Roe v. Wade World
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.
