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 to keep pace with Pharmacy Benefit Managers as they continue to add credentialing requirements that can be extremely difficult, and a significant nuisance, to independent pharmacies.
About Trent Thiede, PharmD, MBA
I started working at Shopko, a community pharmacy, in high school. Shopko was a regional chain, and I worked there for 15 years, holding positions as Pharmacy Manager and Regional Pharmacy Supervisor while completing my PharmD from UW-Madison and MBA from UW-Oshkosh. In 2013, I took over Shopko’s Long-Term Care division and helped divest it to KPH HealthCare (aka Kinney Drugs/HealthDirect). I helped grow their business throughout the Midwest, eventually servicing 20,000 beds in under four years.
I have always been involved in pharmacy audits, and hated recoupments, but didn’t see all the opportunities to combat audits the way PAAS does. PAAS is a small, family-orientated company, and I appreciate the opportunity to help independent pharmacies be more successful.
Entries by Trent Thiede, PharmD, MBA
MedImpact sent a memo to network pharmacies dated May 22, 2023, with the subject line Semglee-YFGN (Preferred U-100 Long Acting Insulin). For their participating Medicare Part D plans, MedImpact requested pharmacies to dispense Semglee® (YFGN) at the brand reimbursement.
While Semglee® was the first interchangeable biosimilar to market back in 2021, Humira has been grabbing attention because of its status as the pharma-GOAT: Greatest Of All Time (in terms of sales) as coined by Doug Hoey from NCPA.
On February 25, 2023, President of PAAS National®, Trent Thiede, had the privilege of participating in a Panel Discussion entitled Marketplace Prescription Dynamics Sure to Shape Your Business Strategies. While traversing several different topic areas, there are two core issues that are important for PAAS members: discount/cash cards and biosimilar adoption in 2023.
The PAAS National® FWA/HIPAA Compliance Program has implemented changes to ensure pharmacies continue to have a robust program in place.
Pharmacy to pharmacy transfers are commonplace in the industry, but much has changed since Lipitor® and Prevacid® were used as currency in a legal drug exchange.
On June 23, 2022 the Drug Enforcement Agency (DEA) created a Guidance Document about the use and posting of guidance documents by the DEA (yes, a guidance document about guidance documents).
Take note – the DEA is coming after pharmacies dispensing illegitimate controlled substance prescriptions. Pharmacists should all be aware of their corresponding responsibility and the need for a legitimate medical purpose when dispensing controlled substance prescriptions.
Community pharmacies have been fed up with PBM antics for a long time. Egregious audits, absurd DIR fees, arduous credentialing requirements, unconscionable contracts; we run out of adjectives before we run out of PBM issues.
Dangers of using Ivermectin to treat or prevent COVID-19. PAAS is seeing more PBM audits on ivermectin prescriptions. Pharmacies should be prepared!