In December 2024, PAAS National®® wrote a Newsline article regarding an international crime ring that found defendants fraudulently billing insurers in a telehealth scheme. On May 19, 2026, one of the defendants was sentenced to 10 years in prison for his participation in the almost $2 billion international health care fraud conspiracy. Two co-defendants were […]
There are continuous developments in the CGM space, with new products, and changing replacement schedules, emerging that pharmacies must be aware of. For example, Dexcom released the Dexcom G7 15-Day Sensor last December. The new product features a longer wear time (up to 15.5 days – with a 12-hour grace period), improved accuracy, and a […]
Staying audit-ready isn’t just about reading the latest guidance – it’s about understanding how it applies to your day-to-day pharmacy operations. That’s why PAAS National®® has launched a new eNewsline Quiz, designed to help pharmacy employees reinforce key takeaways from each Newsline article and ensure the pharmacy is getting the most value from their membership. […]
Pharmacies often find it challenging to comply with the multitude of state and federal requirements. With you in mind, PAAS National®® now offers enhanced customization for community pharmacies within our Fraud, Waste, and Abuse (FWA) and HIPAA Compliance Program that gives pharmacies more control over how their program reflects additional policies and standard operating procedures […]
The first step in getting a new manufacturer/product on the market starts with a manufacturer, repackager, or distributor registering with the FDA to obtain a labeler code (the first set of numbers in the NDC). Once the labeler code is obtained, the company then assigns the product code (middle set of numbers in the NDC) […]
The Office of Inspector General (OIG) announced a work plan being initiated for ‘bad actor’ pharmacies (previously identified by CMS or Part D Plan Sponsors) that continue to bill and receive payment for Part D drugs. OIG has concerns that existing CMS enforcement tools, such as revocation, preclusion, and payment suspension, may not effectively deter […]
As a quick reminder, CMS Form 10882 is a Medicare notice that Plan Sponsors (via CMS directive) require pharmacies to provide patients if a prescription copay for a Medicare Part D claim exceeds $600. The requirement to distribute CMS Form 10882 started January 1, 2025, and is prompted by an Approval Message Code 056. The […]
PAAS National®® alerted pharmacies to the launch of the first ‘generic’ GLP-1 receptor agonist, liraglutide, back in late June 2024. The product released was an Authorized Generic (AG) of Victoza®. In August 2025, another liraglutide product was approved and released to the market as an Abbreviated New Drug Application (ANDA) of Saxenda®. With this release […]
As part of the NCPA 340B task force, PAAS National®®® has advocated strongly that pharmacies should not be required to identify 340B claims. The individual claim’s status is typically unknown at the point of sale, and the process to update claims (N1 information exchange transactions), or reverse and rebill, is arduous. Not only is it […]
Record retention is an important topic pharmacies need to be on top of to ensure compliance. Although a large majority of prescriptions filled by pharmacies are now electronic, other methods such as telephone orders, transfers, faxes, and written hard copies have not been completely wiped from practice. It’s understandable that a pharmacy may be looking […]
