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

CAPS has noticed an increase in pharmacy audits and recoupments for claims prescribed by OIG excluded providers. 

The Office of Inspector General’s (OIG) list of excluded individuals is a database of those persons barred from participating in any federally funded healthcare programs.  This list is specific to the healthcare field. 

CAPS would like to take a moment and remind everyone about some of the yearly compliance requirements.  It is recommended that all pharmacies take a minute and double check that these documents are not expired or the required training has been completed.  Failure to perform the required training could be a breach of contract and lead to potential fines or termination from contracts.