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. 

CAPS recommends that each pharmacy provide a staff member to assist the auditor during the review to ensure that there is adequate time for the auditor to review all of the requested material within their allotted time frame. 

As the audit season is ramping up, CAPS would like to remind you of the benefits of our on-site audit assistance.  For a fee of $ 125 + travel expenses (rental car, gas, food, etc.) you get a nationally certified technician who will work directly with the auditor, allowing your staff to service your patients without interruption.