Many pharmacies are familiar with Prolia® (denosumab) for the treatment of osteoporosis in women after menopause who are high risk for fracture or cannot use another osteoporosis medication (or the other medications weren’t efficacious). There is another denosumab product (brand name Xgeva®) approved for bone problems due to cancer. Prolia® and Xgeva® are not …
Partially dispensing prescriptions is a common, and practical, approach used in pharmacy practice to ensure patients receive timely access to medications when the full prescribed quantity is not immediately available. Rather than delaying therapy, a pharmacy may dispense a portion of the medication and provide the remaining balance at a later time. Partial dispensing most […]
The first year of the Medicare Payment Prescription Plan (M3P) is over and there was a learning curve for pharmacies and patients alike. It took time for pharmacies to understand the program and what was expected. Along with that, PAAS National®® saw new communications from PBMs regarding M3P noncompliance. Around May of last year, OptumRx […]
Pharmacies have sent PAAS National®® notices from Caremark entitled “CVS Caremark Rx Claim Review.” The first line of the notice says, “This communication is for educational purposes only and is not part of an audit.” This has led to many questions and confusion amongst the pharmacies receiving these notices. PAAS has seen waves of these […]
Analysts at PAAS National®® assist with invoice audits on a daily basis. While not as common (in number) as desk audits, the implications of bad audit results are high and can be challenging to appeal. Often questions come up asking why it matters if the exact NDC is billed? A few recent cases from the […]
For independent pharmacies, invoice audits continue to gain traction by the PBMs. While the recently announced WAC decreases make bulk purchasing a potentially precarious scenario, one PBMs also has rigid requirements for “bulk purchasing”.
Successful pharmacies recognize the immense value of team members who are dedicated, diligent, knowledgeable, and reliable. With the financial squeeze in community pharmacies, payroll can be a tough spot to spend extra money. Having the employee fill prescriptions at the pharmacy they work in, and not having them pay the resulting copay, can be a […]
Pharmacies across the country are receiving a second notice from AstraZeneca regarding Farxiga® discrepancies. As before, there are two versions of this letter but now AstraZeneca is asking pharmacies for specific information and actions.
Across the country, health care fraud affects all areas of the healthcare system, but how does it affect your pharmacy? Bad actors in pharmacy give validation to PBM audit practices, adding to the audit burden. PBMs leverage these audits as a method to keep the “bad actors” out of the health care field and save […]
Community pharmacies are always looking for ways to provide better care for patients. A primary focus continues to be on customer service – whether it be cost savings on prescriptions, convenience of delivery or med-sync programs. When a patient presents to the pharmacy with a new prescription, the focus is on education and adherence. Wouldn’t […]
