CAPS would like to remind our member pharmacies of CVS/Caremark’s Manufacturer Coupon/Program Policy.

This issue of the CAPS Newsletter discusses the following topics: 

• X-DEA Prescription Requirements
• Prescriptions Written by a Nurse Practitioner (NP) or Physician Assistant (PA)
• Insulin Part B vs. Part D Billing
• NDC Number does NOT mean a Product is "FDA Approved"
• PBM Processing Exclusion for Non-FDA Approved Drugs
• “Use as Directed”, “As Directed”, “Per Sliding Scale” Directions
• Prescription Origin Codes
• DAW Codes (According to CMS.gov)
• OIG/SAM Monthly Exclusion Checks 
• CAPS Department Contact Information

• This issue of CAPS Newsletter discusses the following topics:

  
  

  • X-DEA Prescription Requirements
  • Prescriptions Written by a Nurse Practitioner (NP) or Physician Assistant (PA)
  • Insulin Part B vs. Part D Billing
  • Issuance of Multiple Schedule II Prescriptions
  • Biennial Controlled Substance Inventory Count
  • “Use as Directed”, “As Directed”, “Per Sliding Scale” Directions
  • Multiple Physicians Listed on a Prescription
  • Humana Audit $5 Penalty Fee
  • OIG/SAM Monthly Exclusion Checks 
  • Meet your CAPS Team

Precluded Prescriber

In accordance with CMS Final Rule CMS-4182-F, CVS Caremark will begin rejecting any claims prescribed be an individual on the Preclusion List effective April 1, 2019.  Claims will reject with the following or similar:

INSIDE

From the auditor’s desk. . . . . . . . . 1

Medicare news/Medicaid news . . 2

Florida news. . . . . . . . . . . . . . . . . . 4

Minnesota news. . . . . . . . . . . . . . . 4

Prime news. . . . . . . . . . . . . . . . . . . 5

Processing Update. . . . . . . . . . . . . 6