Diabetic Test Strip Authorized Distributors
Independent pharmacies continue to receive threatening letters regarding the purchase of LifeScan OneTouch® test strips.
Entries by Eric Hartkopf, PharmD
DMEPOS Updates: Annual Reaccreditation Surveys, New Site Visit Service Contractors
PAAS National®® wants to alert members to a few recent changes that may impact pharmacies who are dispensing DMEPOS supplies to Medicare patients.
Medicare Transaction Facilitator (MTF) Updates
We are now one month into 2026, and pharmacies are feeling the impact of the Medicare Part D Drug Price Negotiation Program (MDPNP). Hopefully your pharmacy is getting more comfortable …
$300,000 Settlement for Employing Excluded Individual
The U.S. Attorney’s Office for the District of New Hampshire recently announced a $300,000 settlement with a telehealth company and its owner to resolve allegations of improper Medicaid billing under the False Claims Act. The government alleged that the company billed Medicaid for services provided by an individual who was excluded from participation in federal […]
OIG Report: Medicare Payments for Continuous Glucose Monitors
A recent OIG report found that Medicare may be overpaying suppliers for Continuous Glucose Monitors (CGMs) and supplies relative to other payers. The report highlighted the following: As a result of the findings, OIG has recommended that CMS reduce payments for CGMs and supplies and address improper use of billing codes to reduce overpayments. CMS […]
Eye Drop Chart Updates
PAAS National®® analysts have identified a recent trend of audit enforcement related to days’ supply for eye drops, with a particular focus from Prime Therapeutics. Most PBMs provide a “drops per mL” estimate in their provider manual, but they often provide a qualifier that pharmacies should use the PBM estimate “unless otherwise indicated by the […]
OIG Report: $22.7 Million in Improper Payments for DMEPOS During Inpatient Stays
The Office of Inspector General (OIG) recently released a report outlining $22.7 million in improper payments from 2018-2024 for DMEPOS provided during inpatient stays. This was a follow up to a previous report issued in 2018 that found over $34 million in improper payments from 2015-2017. The CMS identified system edits that were not working […]
Medicare Drug Price Negotiation: MTF Data Module Enrollment & Caremark Attestation
Starting in 2026, Medicare has negotiated the price of 10 brand drugs under the Medicare Drug Price Negotiation Program as part of the Inflation Reduction Act of 2022. The negotiations between CMS and drug manufacturers have resulted in Maximum Fair Prices (MFPs). To implement this program, CMS has created the Medicare Transaction Facilitator (MTF) which […]
USP 800: What Community Pharmacies Need to Know
Most community pharmacies don’t compound with hazardous drugs, but that doesn’t mean you’re off the hook when it comes to USP 800 compliance. This standard, USP General Chapter <800> Hazardous Drugs: Handling in Healthcare Settings, applies to anyone who receives, stores, or dispenses hazardous drugs (HDs). And yes, that includes community pharmacies. What Makes a […]
