Why Does Billing the Correct Origin Code Matter?

Pharmacies are required to enter an origin code on claims to indicate where the prescription came from or “originated.” By definition, an origin code cannot change and should remain billed as how the pharmacy originally received the prescription from the prescriber, even when clarifications of that prescription are done by telephone.

Why does billing the correct origin code matter?

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In general, origin code errors are educational with a few exceptions. Humana will charge a $5 penalty fee for an incorrect origin code being billed when discovered on audit. This will be for the original claim and each refill also billed incorrectly (e.g., original fill plus 11 refills = $60 recoupment). If a telephone order is sent in for audit when billed with a different origin code, some auditors will assume the pharmacy could not find the “original” prescription and simply wrote one up. Auditors will mark the claim discrepant until the pharmacy can produce the prescription with the correct origin code or obtain a prescriber statement. Additionally, with Medicare Part D now requiring electronic prescribing of controlled substances (EPCS), CMS will rely on the origin code (initiated by the pharmacy) in the Prescription Drug Event (PDE) data to determine if physicians are adhering to the requirements.

NCPDP defines origin code values as follows:

CODE DESCRIPTION
0 Not Known
1 Written – Prescription obtained via paper.
2 Telephone – Prescription obtained via oral instructions or interactive voice response using a phone.
3 Electronic – Prescription obtained via SCRIPT or HL7 Standard transactions, or electronically within closed systems.
4 Facsimile – Prescription obtained via transmission using a fax machine.
5 Pharmacy – This value is used to cover any situation where a new Rx number needs to be created from an existing valid prescription such as traditional transfers, intrachain transfers, file buys, software upgrades/migrations, and any reason necessary to “give it a new number.” This value is also the appropriate value for “Pharmacy dispensing” when applicable such as BTC (behind the counter), Plan B, established protocols, pharmacists authority to prescribe etc.

Here are questions PAAS National® has frequently answered:

Question 1: If a pharmacy calls a prescriber to clarify a written prescription, or a change is needed, does the origin code become a “2” for Telephone?

Answer: No, the NCPDP Telecommunication FAQ section 3.1.5.3 states, “Because the prescription was received via written form the Prescription Origin Code is 1 and will remain a 1 throughout the life of the prescription number.” The same would be true if received by any other origin.

Question 2: If a prescriber sends a prescription electronically, but the pharmacy is not electronically-prescribing enabled or if there is a transmission error, and the intermediary drops the prescription to a fax, what origin code is used?

Answer: Per NCPDP, “Because the prescription was received at the pharmacy via fax the Prescription Origin Code is 4 and will remain a 4 throughout the life of the prescription number.”

Question 3: What origin code is used for a standard written authorization or protocol for services and products like, vaccines or Narcan®?

Answer: The NCPDP definition for protocols is Prescription Origin Code of “5” since the prescription is created by the pharmacy in these cases.

PAAS Tips:

  • Always bill the correct origin code to avoid potential recoupment.
  • The origin code remains the same through the life of the prescription.
  • Too many incorrect origin code discrepancies can lead to more frequent audits.
  • See the NCPCP Telecommunication Version D and Above Questions, Answers and Editorial Updates document for more information and scenarios.

Medicare Caps Copay for Insulin at $35 per Month

As most of you (and your Medicare patients) have undoubtedly noticed, Medicare has applied a $35 per month cap on copays for insulin prescriptions ($105 for a 3-month supply) for years 2023-2025. For 2026 and beyond, copays will be capped at the lesser of $35 or 25% of the negotiated price.

Section 11406 of the Inflation Reduction Act of 2022 implemented this cap for Medicare Part D and Medicare Advantage patients effective January 1, 2023, while Section 11407 requires implementation for Medicare B covered insulin as of July 1, 2023.

Plan Sponsors have a 90-day grace period to implement these copay caps and any excess copays calculated at adjudication must be refunded by the plan.

PAAS Tips:

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  • The definition of “one month” varies by plans
  • Pharmacies should collect the full copay amount as per online adjudication and advise patients that the plan will refund patients for any amounts in excess of $35 per month
  • Pharmacies should be extra diligent when calculating days’ supply and make sure you have mathematical instructions that support the days’ supply adjudicated
  • See the Insulin Medication chart and Can You Bill It As 30 Days? tool on the PAAS Member Portal for additional guidance
  • The CMS has created the following resources for Medicare patients
    • 7 Things to Know about Medicare Insulin Costs
    • Frequently Asked Questions About Medicare Insulin Cost-Sharing Changes in the Prescription Drug Law

Multi-Language Insert Must Be Provided to Medicare Beneficiaries as of January 1, 2023

After reading this article you should understand what a multi-language insert is, why it must be provided, and when you are required to hand it out.

What is a multi-language insert (MLI)?

You have likely seen a MLI if you have received any written communication from your health plan. The document will offer free interpreter services along with a phone number to call to ask questions about your health or drug plan.

Specific details about what a MLI must contain can be found in 42 CFR § 423.2267(e)(33), “This is a standardized communications material which states, ‘We have free interpreter services to answer any questions you may have about our health or drug plan. To get an interpreter, just call us at [1-xxx-xxx-xxxx]. Someone who speaks [language] can help you. This is a free service.’ in the following languages: Spanish, Chinese, Tagalog, French, Vietnamese, German, Korean, Russian, Arabic, Italian, Portuguese, French Creole, Polish, Hindi, and Japanese.”

Why must a multi-language insert be provided?

Notification of this requirement was published on May 9, 2022 in the Federal Register, 87 FR 27704. According to the notice, 12.2 percent of persons aged 65 and older speak a language other than English in their home. The multi-language insert is meant to inform individuals that free interpreter services are available to them. This helps ensure that all patients are provided equal access to care across all patient populations. For more information about providing equal access, contact PAAS National® at (608) 873-1342 to learn more about our Cultural Competency and Linguistically Appropriate Services using the PAAS CARE Model.

When must a multi-language insert be handed out?

According to 87 FR 27704, the insert must be handed out “whenever a Medicare beneficiary is provided a CMS required material.” Lists of CMS-required materials can be found under 42 CFR§ 422.2267(e) and 42 CFR § 423.2267(e). Pharmacies would be directly impacted by 42 CFR § 423.2267(e)(21) – “Medicare Prescription Drug Coverage and Your Rights. This is a standardized communications material used to convey a beneficiary’s appeal rights when a drug cannot be filled at point-of-sale.” Since pharmacies are required to hand out the Medicare Prescription Drug Coverage and Your Rights form (CMS 10147), a CMS-required document, the MLI must be provided concurrently.

PAAS Tips:

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  • Auditors often confirm pharmacies are distributing the current version of CMS 10147 to Medicare beneficiaries, as required, and now they may look for the MLI as well (Elixir has explicitly stated that they will review this during onsite audits)
  • There is no requirement for pharmacies to document the distribution of the MLI
  • The phone number on each MLI is PBM-specific; if a MLI is not automatically generated by your software system with a populated phone number, we suggest utilizing the numbers below (TTY numbers are for people who have hearing loss or speech impairment which makes using a regular telephone difficult; conversations are typed instead of vocalized):
  • For additional details regarding MLI, refer to 42 CFR§ 422.2267(e) and 42 CFR § 423.2267(e)

Ozempic and Mounjaro Prescriptions – Between a Rock and a Hard Place

Many pharmacies continue to receive new prescriptions from patients eager to start on therapy for Ozempic® and MounjaroTM. Oftentimes, these patients are hopeful and excited to start on this long-term therapy to help manage their underlying indication and may quickly become upset and confrontational with your staff if they are told “we don’t have this in stock”, “this medication requires a prior authorization” or “I don’t think this is covered by your insurance unless you have type 2 diabetes”.

Glucagon-like peptide-1 (GLP-1) receptor agonists like Ozempic® and MounjaroTM  have recently gone viral on social media and are the hottest craze in Hollywood for a very desirable side effect – weight loss. As a result, many prescribers have prescribed them “off-label” for indications such as weight loss, pre-diabetes and metabolic syndrome, despite having been only FDA approved for type 2 diabetes. While off-label prescribing is common and perfectly acceptable in medical practice, pharmacies become stuck not knowing whether a patient’s insurance company pays for these medications in the absence of a type 2 diabetes diagnosis. Pharmacies report that many patients are presenting these prescriptions after having previously received prescriptions for Saxenda® or Wegovy® (that were not covered by insurance) or having been turned away by other pharmacies.

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Some Payors have implemented Utilization Management tools such as Prior Authorization or Diagnosis Restriction to confirm why the patient is using the medication before paying (or denying) the claims – in these situations the pharmacy should be much less concerned.

  • There is not a known list of “acceptable” diagnosis codes for PBMs or Plans
  • If the PBM has not designated the particular NDC as diagnosis restricted, then any diagnosis codes (ICD-10) submitted by the pharmacy are likely not reviewed, and pharmacies should not assume the PBM used the code as part of adjudication logic to determine payment of claim

When claims for GLP-1 medications pay at point-of-sale without any utilization management, PBMs may still expect pharmacies to “police” these medications and be able to accurately tell patients that the drug is covered or not covered (PAAS Audit Assistance members can see Mounjaro Off-Label Use for Weight Loss Spells T-R-O-U-B-L-E from November 2022). Inevitably, this puts pharmacy staff between a rock and a hard place when patients are using medications off-label.

  • For patients with type 2 diabetes (ICD-10 diagnosis code “E11”), pharmacies can bill insurance and follow corresponding claim adjudication logic without additional concerns.
  • However, for any other diagnosis the pharmacy should consider stating: “I don’t know if your insurance covers for indication X”.

Understandably, pharmacies have a difficult time determining if an individual patient’s insurance company will approve coverage for a GLP-1 medication for conditions other than type 2 diabetes. Researching plan benefits is often an exercise in futility, and PBM help desks are unlikely to have the clinical expertise.

The risk of a future PBM audit looms and it would be easy for a crooked PBM to pay the claim now, audit the pharmacy later and argue that “you (the pharmacy) should have known that we (the PBM) only cover this drug for type 2 diabetes”. Is this fair? Absolutely not, but when was the last time PBM audits were fair?

Consider these audit discrepancies from MedImpact:

  • The diagnosis code of the corresponding medical claim does not support the billing of this medication
  • There is no corresponding medical claim to support the billing of this medication

While these claims were not related to Ozempic® or MounjaroTM, they easily could have been. With vertical integration amongst PBMs and Health Insurers, it’s easy to see how data could flow amongst them to identify off-label drug utilization; and with an annual treatment cost of nearly $12K per year, payors are going to look to reduce its utilization.

Dispensing these medications, when you can even get them in stock, is very complicated based on the large sticker price, the risk of audit and the immediate backlash you may face from patients and local prescribers if you say “no” or even “let’s try to figure this out”.

PAAS wants to help you and your patients get access to prescribed therapies and we recognize that refusing to fill prescriptions is not good for business or customer satisfaction. While there is not a one-size-fits-all approach, here are some best practice suggestions to keep your pharmacy safe from audit and create the fewest waves with parties involved.

PAAS Tips:

  1. All prescriptions for GLP-1s should be verified for indication of use
    1. Check patient profile for previous use of type 2 diabetes medications as a proxy
    2. Check the prescription to see if it came with a diagnosis code
    3. Contact the prescriber to confirm indication and document a clinical note
  2. If patient has E11 type 2 diabetes mellitus, then you should have limited concerns
    1. Your pharmacy will need to determine which other diagnoses you are comfortable billing to insurance without questioning further
  3. If claim requires prior authorization or is diagnosis code restriction (regardless of patient diagnosis), follow standard processing procedures
  4. All other claims pose audit risk and the pharmacy should consider giving the patient options to proceed
    1. Explain to the patient that insurance may not cover without type 2 diabetes diagnosis
    2. If indication is for weight loss, pursue prescription for Saxenda® or Wegovy® first, as these two medications are FDA approved for weight loss
      1. Medicare Part D currently excludes coverage of weight loss agents as per CMS Prescription Drug Benefit Manual Chapter 6, section 20.1
      2. The “Treat and Reduce Obesity Act of 2021” (HR 1577) was introduced in 2021 to allow coverage of prescription drugs for treatment of obesity or weight loss, however this bill is not a law
    3. Explain that the pharmacy wants to help them get their medication, but due to the high cost (>$1,000 per month) it is important to confirm coverage, which can take time
      1. If the patient is willing to wait a few days to start therapy, pursue 4b above (if this hasn’t been explored) and encourage the patient to contact their insurance to confirm coverage for their condition. Note that the PBM help desk is unlikely to have clinical knowledge and patient (or pharmacy) would need to speak with clinical staff such as prior authorization department
  5. If you bill insurance and claims are subsequently audited, PBMs may try to recoup payment of claims if patients do not have type 2 diabetes
    1. Should this occur, PAAS is here to support you throughout the audit process with strategies and resources to fight the recoupments

PBM Prescription Validation Requests Rose Nearly 20% in 2022!

Prescription Validation Requests (also known as claim reviews) are becoming a more frequent occurrence with many PBMs. In 2022, PAAS saw an 18% increase year over year. Some of the reasons these claims get flagged include:

  • High dollar claims
  • High quantity to days’ supply ratios
  • NDC package size mismatched to quantity billed

While these requests are a nuisance, they can work to the pharmacy’s benefit. With the PBM looking at the claim prospectively (before payment is received), pharmacies can avoid incorrectly refilling medication if an error is detected. Conversely, if a pharmacy is not prompted to correct an error (when one exists) and the claim is refilled over the course of a year, the financial recoupments can be much greater upon audit. The frustration comes in when these claim reviews are repetitious, and false positives (i.e., no billing errors) – creating work for the pharmacy without the need for claim correction.

Below is a chart of the various PBMs conducting these prospective reviews and the details/nuances associated with each. OptumRx/EXL® makes up the majority of these pre-claim reviews that members report to PAAS. OptumRx defines the Prescription Validation Request (PVR) in their pharmacy manual as follows:

Administrator conducts limited scope prescription validation reviews for quality assurance purposes (“PVRs”), which are distinct from and are not considered audits. PVRs are utilized to verify the accuracy and validity of prescription claim submissions. Claims are monitored daily for appropriateness and potential billing errors and selected for review prior to payment. Network Pharmacy Providers are typically contacted via fax or email and asked to provide photocopies of specific documents and records related to its claims submitted to Administrator.

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PBM Title of Request Days to Respond Targeted Claims
Caremark® Concurrent Claim Review 3 Compounds, non-FDA approved products, injections
Express Scripts® Claims for Investigative Review 5 CII’s
Humana® Pharmacy Claim Validation Request 3 business Potentially misbilled claims

(Unusual quantity and days’ supply combination)
MagellanRx/Conduent Claim Check verification review 7 High dollar (Emgality ®, insulin)
MedImpact Pre-pay Claim Review 3 business Potential billing errors

(Unusual quantity and days’ supply, incorrect DAW code)
OptumRx/EXL® Validation Request 14 business High dollar (Humira®, Enbrel®, insulin, inhalers)
Prime Therapeutics Initial Documentation Request 2 High-dose insulin

While PBMs have fancy names for these requests, make no mistake: if it looks like an audit, you must submit documentation like an audit, and you get results (and recoupments) like an audit, it is an audit!

PAAS Tips:

  • Send the validation review request to PAAS National® right away as these can often have short deadlines
    • Include a copy of the prescription and your backtag for the date of service in question so that we can verify claim billing
  • Most requests do NOT require a signature log, but PAAS will confirm if required after reviewing your audit notice.
  • Often, these claims are very recent and sometimes have not even left the pharmacy
  • A response is required even if claim has been reversed
  • If a claim is recent (within) 30 days, and there is a billing error, the pharmacy can often correct the claim (if applicable)
  • If the PBM finds the claim to be accurately billed, the pharmacy will not receive any “results”
  • Even though these requests are not typically labeled as an “audit”, PAAS has seen PBMs deny payment on the claim and/or issue “results”
  • If the pharmacy received what looks like “results,” send to PAAS for guidance. The “results” may list an estimated overpayment amount which is often a consequence of external auditing entities not having real time claims access

XDEA Numbers Have Been NiXed…but Not the Training

When you are preparing for an audit, a PAAS National® analyst has likely told you to ensure a prescriber’s Drug Addiction Treatment Act (DATA) 2000 Waiver ID, or XDEA number, is included on prescriptions for medications used to treat opioid use disorder along with their regular DEA number. Effective December 29, 2022, the date the Consolidated Appropriations Act of 2023 (“The Act”) was signed, the need for prescribers to have XDEA numbers to prescribe such medications has been eliminated.

Subsequently, on January 12, 2023, the DEA released an informational document. In it, they state their support regarding the policy reform, stating, “At DEA, our goal is simple: we want medication for opioid use disorder to be readily and safely available to anyone in the country who needs it [and] the elimination of the X-Waiver will increase access to buprenorphine for those in need.” The document goes on to state “going forward, all prescriptions for buprenorphine only require a standard DEA registration number” but cautions that state laws and regulations still apply.

The Substance Abuse and Mental Health Services Administration (SAMHSA) echoes the DEA’s sentiment, stating “all practitioners who have a current DEA registration that includes Schedule III authority, may now prescribe buprenorphine for Opioid Use Disorder in their practice if permitted by applicable state law…”

Despite the X-Waiver no longer being mandatory, the Act did enact a new training requirement. In Chapter 6 of the Act is Section 1263 entitled “Requiring Prescribers of Controlled Substances to Complete Training”. It discusses ways to meet training requirements, such as prescribers completing no less than 8 hours of training on the treatment and management of patients with Opioid Use Disorder in a variety of settings. Currently, DEA and SAMHSA are working together to implement the new training requirement and state that this requirement will not go into effect until June 2023.

PAAS Tips:

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  • PBMs and third-party payors are often mute on these topics, leaving pharmacies guessing on appropriate actions (and corresponding audit risk)
    • Comply with state and federal requirements for controlled substances
    • For prescriptions written prior to 12/29/2022, ensure the XDEA number is present on the prescription
    • If the pharmacy is filling/refilling a prescription written prior to 12/29/2022 and the provider did not have an XDEA number at the time, the prescription would likely be considered invalid by PBMs (and the DEA), and PAAS would suggest [conservatively] to get a new order from the provider

Beware: Caremark is Monitoring High Quantity Utilization and Atypical Dispensing Habits

Beyond traditional desktop, on-site, investigational or invoice audits, Caremark performs various compliance reviews. These compliance reviews may include:

PAAS National® has recently reviewed a second round of these Rx Claim Review notices from members. While new for Caremark, PAAS has identified multiple versions of the letter primarily focusing on two areas of concern:

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  1. Dispensed quantities of medications that are significantly higher than the average fill size
    1. Primarily seen with Diclofenac Gel 1%, Lidocaine 3% cream, Ketoconazole 2% cream and diabetic testing supplies (i.e., lancets, needles, strips, and syringes)
  2. Atypical dispensing activity (e.g., disparate prescriber to pharmacy ratio)
    1. Primarily seen with Duexis® and Pennsaid®

The brief, and poorly worded, letter states the pharmacy should evaluate the claims in question and consider whether the dispensing of these medications is appropriate. It concludes with “your cooperation is appreciated and will greatly assist us in our review”. Due to the ambiguous direction, pharmacies are unsure if they need to respond or provide any additional information or documentation to Caremark.

PAAS Tips:

  • The notices PAAS has reviewed do not require a formal response
  • Caremark wants the pharmacy to evaluate the claims
    • For claims listed as having a high quantity utilization, pharmacy can verify the quantity and days’ supply dispensed for appropriateness
    • For claims listed as having atypical dispensing habits, pharmacy should validate the claims are billed under the correct prescriber, that there is a valid physician-patient relationship, and that the prescriptions are not being solicited
  • Every pharmacy’s situation is different and PAAS can help provide perspective and next steps
  • See Caremark Expands “Aberrant” Language & Restricts Bulk Purchases from February 2022 Newsline for additional information on Aberrant Practices and Trends

Criminal HIPAA Charges Filed Against Compounding Pharmacy Sales Rep

Criminal HIPAA charges are not handed down frequently, but when an individual “knowingly” and inappropriately obtains and discloses a patient’s protected health information (PHI), they could face up to $50,000 in fines and up to one year in prison, according to 42 U.S.C. § 1320d-6. Additionally, if found guilty of obtaining or disclosing the information with the intent to sell, transfer, or use the PHI for commercial advantage, personal gain, or with malicious intent the penalties can increase up to $250,000 and 10 years in prison.

According to a October 20, 2022 Department of Justice press release, a former compounding pharmacy sales representative located in New Jersey is facing criminal HIPAA charges for obtaining unauthorized access to PHI with the intent to personally profit. The sales rep promoted compounded prescriptions and other medications which were subsequently filled by a Louisiana pharmacy. The sales rep and his co-conspirators knew which plans would reimburse significantly for certain compounded medications and the sales rep then recruited patients with that specific insurance. To do this, the sales rep gained access to a medical clinic where the doctor allowed him to have significant access to patient medical records. Since the sales representative was not an employee of the doctor’s office, he was not authorized to access the information without first obtaining proper release. The sales rep would then sift through medical records to identify patients with the sought-after insurance plan. The patient files would be tagged so the doctor could easily identify patients with the specific insurance plan so he knew whom he should prescribe the compounds. On occasion, the sales representative would even join the doctor and patient in the exam room as if he were employed by the medical office, which he was not.

Patients were targeted based on information illegally gained from within secure patient records, then they were prescribed and dispensed medically unnecessary compounded medications all as a result of this scheme.

Training staff to appropriately handle PHI, and discussing the consequences of mishandling PHI, is critical to preventing a breach and other unauthorized access to protected information—malicious or not. If you have not already taken advantage of the PAAS National® Fraud, Waste, and Abuse and HIPAA Compliance Program, now is a great time to reach out to a PAAS staff member to learn about the best program available to independent pharmacies. Ring in the New Year with confidence knowing that you have a method to provide your staff with comprehensive, community pharmacy focused HIPAA training.

Valid Prescriber/Patient Relationships and Marketing Concerns

With the U.S. Department of Health and Human Services Office of Inspector General’s (OIG) recent focus on telemedicine fraud, pharmacies may be wondering what their obligations are when determining a prescription’s authenticity – especially when it comes to whether a valid prescriber/patient relationship exists. Many PBMs, including Express Scripts, TRICARE, CVS Caremark, and OptumRx all have language in their provider manuals placing the responsibility on the pharmacy of ensuring a valid prescriber/patient relationship exists.

How can you determine if a prescriber/patient relationship is valid? Questions you may ask to verify this are:

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  • Does the patient regularly see this prescriber?
  • Does the patient live in the same area where the prescriber’s office is located?
  • Would you be able to obtain medical records to validate this relationship if needed?
  • Can you confirm the patient is aware of and requested the prescription?

Along with telemedicine, PBMs are also concerned about marketing practices of pharmacies. The provider manuals for Express Scripts, TRICARE, CVS Caremark, OptumRx, and Elixir all contain language surrounding what is not allowed and some, like Express Scripts, are known for using investigational audits to ensure compliance.

Prohibitions on certain marketing practices in these manuals include, but are not limited to:

  • Acquiring potential patients, either directly or from a third-party by referral, using door-to-door, telephonic or other cold-call tactics.
  • Obtaining the patient’s provider or billing information without the patient’s consent.
  • Using fraudulent, abusive, or deceptive television or internet advertisements or emails.
  • Contacting a patient or prescriber without a previously existing relationship.
  • Contacting or offering to contact a prescriber on a patient’s behalf without the patient’s express knowledge and authorization.
  • Obtaining a prescription from a prescriber by suggesting to a patient that the prescriber or patient’s health plan wants the patient to receive the medication without the prescriber’s knowledge and authorization.
  • Limiting a patient’s right to use a different pharmacy of the patient’s choice or use marketing techniques that may make a patient believe they are restricted to your pharmacy.

Pharmacies must remain vigilant and always conduct marketing practices in a manner consistent with their state laws, federal laws, and Medicare regulations and guidelines.

PAAS Tips:

  • Make every effort to confirm a patient authorized prescriptions coming from unusual prescribers
    • Consider, amongst other things, the prescriber’s scope of practice and location to patient/pharmacy
  • Know your state and federal laws surrounding marketing practices
  • See the Medicare Communications and Marketing Guidelines for specific guidance
  • Develop policies and procedures surrounding marketing practices to ensure compliance
  • See the following Newsline articles for additional tips:
  • To get started with your customizable FWA and HIPAA Compliance program contact PAAS National® today, (608) 873-1342 or info@paasnational.com.

Top 10 PAAS National Articles of 2022

PAAS Audit Assistance members receive a monthly newsletter with new audit tactics and prevention tips. The printed newsletter, PAAS National® Newsline is only a fraction of the content that we put out each month as members have access to additional content online in the Member Portal, in addition to an archive of articles.

The top 10 Newsline articles for 2022 include:

  1. Use and Posting of Guidance Documents by DEA – What’s Changed with Controlled Substance Annotations?
  2. Mounjaro™ Off-Label Use for Weight Loss Spells T-R-O-U-B-L-E
  3. Risks when Filling a Prescription with Two NDCs
  4. Breaking Insulin Pen Boxes: Where Are We Now?
  5. Understanding Caremark’s Restrictions on Bulk Purchases
  6. When Should I Obtain a Diagnosis Code for Ozempic?
  7. Top Medications Flagged for Unauthorized Substitutions
  8. Cash Copy Collection
  9. Caremark® Expands “Aberrant” Language & Restricts Bulk Purchases
  10. COVID-19 OTC Home Test Kits Required Coverage as of January 15, 2022

Top eNewsline Exclusives: Articles that did NOT make print

PAAS Audit Assistance Admins can also keep their employees informed to increase engagement and lower audit results by adding employees to the Portal so that their whole staff has access to the eNewsline.