PAAS National®®® continuously monitors legislative and regulatory changes that may impact your Fraud, Waste & Abuse and HIPAA Compliance Program. We keep a close eye on enforcement from the Department of Justice, Office of Inspector General, State Attorney Generals, and Office for Civil Rights to help ensure the program meets interpretative standards. Furthermore, PAAS works […]
In December 2024, PAAS National®® brought you the Medicare Part B Coverage of HIV PrEP Newsline article which provided an in-depth look into appropriately billing HIV PrEP medications to Medicare Part B. The original shift from billing these medications from Medicare Part D to Part B was effective just a few months ago (September 30, […]
As of September 30th, 2024 there was an industry shift from billing HIV Pre-Exposure Prophylaxis therapy (PrEP) from Medicare Part D to Medicare Part B. This shift to Part B coverage falls under section 1861(ddd)(1) of the Social Security Act using the “additional preventative services” benefit. Due to the high cost of HIV PrEP medications, […]
Pharmacy personnel are all tasked with keeping patient protected health information (PHI) secure.
Correctly billing Medicare Part B can be tough. The Local Coverage Determinations and associated Policy Articles for each DMEPOS category, along with the Standard Documentation Requirements for All Claims Submitted to DME MACs, are filled with billing and documentation guidelines which suppliers must fully comprehend and follow to avoid claim chargeback.
OptumRx® updates their Provider Manual several times throughout the year and publishes the full version on its publicly available webpage.
Safeguarding the pharmacy’s Protected Health Information (PHI) is critical.
Safeguarding the pharmacy’s Protected Health Information (PHI) is a MUST for all staff expected to come in contact with this sensitive information.
PAAS National® analysts are receiving numerous inquiries regarding the substitution of Januvia®, Zituvio® and sitagliptin.
Imagine getting a papercut then moments later, cleansing your hands with alcohol hand sanitizer—you can almost feel the instantaneous sting the alcohol causes in the fresh wound. Not only are you subjected to the initial affliction, but also the second round of pain from the alcohol in the wound.
