PHARMACY NETWORK. 1st Quarter Newsletter 2016

Transcription

1 PHARMACY NETWORK 1st Quarter Newsletter 2016

2 Table of contents Important announcement 1 Credentialing 2 FDA communications 2 Safety warning 2 PerformMAX portal 3 Medicare and Medicaid news 3 Recalls 4 Pharmacy information 5 Did you know? 5 Pharmacy issues 5

3 Important announcement Pharmacy audits PerformRx has engaged Integrated Pharmacy Solutions Inc. (IPS) to conduct pharmacy claims and credentialing audits of the pharmacies in our network. Our pharmacy audits focus on education, quality of service, appropriate filling and billing, compliance with applicable state and federal laws and regulations, and credentialing. You can be assured that a team of highly experienced and dedicated pharmacy professionals conducts all IPS audits. Your cooperation is essential for a successful audit experience. Please take time to work with the auditors and have hard-copy prescriptions, signature logs and supporting documentation readily available during the onsite portion of any audit. 1

4 Credentialing Since 2007, we have been nationally recognized as a URAC-accredited pharmacy benefit manager. The URAC accreditation demonstrates to consumers that PerformRx and our participating network pharmacies are committed to providing exceptional quality and safe care. PerformRx requires all participating pharmacies to submit the following credentialing documents: Facility state licensure information, including current license(s) and history of licensure; Drug Enforcement Agency (DEA) registration or state-controlled dangerous substance certificate, as applicable; and General liability, professional liability, and workers compensation insurance coverage that meets the minimum limits required by PerformRx. All credentialing documentation must be provided to PerformRx upon request. If no response is provided when requested by PerformRx, pharmacies may be put on a corrective action plan or removed from the network. FDA communications The U.S. Food and Drug Administration (FDA) periodically issues safety alerts related to drugs, biologicals and medical devices. These alerts include safety issues, risks and product recalls. To access the most recent Safety Alerts for Human Medical Products, please go to: SafetyAlertsforHumanMedicalProducts/ucm htm. Safety warning (informational only) The FDA alerted health care professionals of a voluntary recall of morphine sulfate 0.5 mg/ml preservative free in 0.9 percent sodium chloride, 1 ml syringe, CII, for intravenous use made and distributed by Pharmakon Pharmaceuticals in Noblesville, Indiana, because the product is super-potent. Pharmakon initiated the voluntary recall on February 11, 2016, after receiving laboratory results showing the product was super-potent. On February 16, 2016, the FDA was alerted of serious adverse events in three infants associated with the use of the recalled morphine sulfate products from Pharmakon. Injecting a patient with super-potent morphine could result in serious consequences including respiratory depression, coma and death. The recalled product was made on February 3, 2016, with an expiration date of March 19, 2016, and labeled lot E52418EV11C and NDC The recalled product was distributed to two medical facilities one in Indiana and one in Illinois. Health care professionals should immediately check their medical supplies and quarantine the recalled product. Morphine sulfate 0.5 mg/ml preservative free in 0.9 percent sodium chloride by Pharmakon Pharmaceuticals: Recall Super-potent product Posted February 17,

5 PerformMAX portal For Medicare Part D plans, the PerformMAX pharmacy portal provides you with access to our maximum allowable cost (MAC) pricing tool search. When registering for the first time, be sure to register as a pharmacy in the user type field. To access PerformMAX, please use this link: Medicare and Medicaid news CMS National Provider Identifier (NPI) requirement changes Effective January 1, 2016, the Centers for Medicare & Medicaid Services (CMS) began enforcing its prescriber National Provider Identifier (NPI) requirement. Previously, CMS required Part D sponsors to pay a claim even when the pharmacy did not include a correct or valid prescriber NPI. Section 507 of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) states that a Part D sponsor cannot pay a claim that does not have an active and valid Type 1 prescriber NPI unless the pharmacy corrects the NPI or confirms that it is active and valid. 3

6 Recalls lot level only Product description Code info Classification Reason for recall Recalling firm Lyrica (pregabalin) capsules, 50 mg, 90-count bottle, Rx only, distributed by Parke-Davis, division of Pfizer Inc., NY, NY 10017, NDC Lot # M07861, Exp. 5/2018 Failed tablet/capsule specifications: Firm is recalling specific lots of pregabalin capsules due to the potential presence of deformed or damaged capsules. Pfizer Inc. Lyrica (pregabalin) capsules, 75 mg, 90-count bottle, Rx only, distributed by Parke-Davis, division of Pfizer Inc., NY, NY 10017, NDC Lot # M07862, Exp. 5/2018; M07865, Exp. 6/2018 Failed tablet/capsule specifications: Firm is recalling specific lots of pregabalin capsules due to the potential presence of deformed or damaged capsules. Pfizer Inc. Nystatin, USP powder for Rx compounding, 50 million units, packaged by Perrigo, Minneapolis, MN 55427, NDC , UPC Lot # , Exp. 2/2016 Labeling: Label error on declared strength. Perrigo Company PLC Nystatin, USP powder for Rx compounding, 150 million units, packaged by Perrigo, Minneapolis MN 55427, NDC , UPC Lot # , Exp. 2/2016 Labeling: Label error on declared strength. Perrigo Company PLC Clonazepam tablets, USP, 0.5 mg, 100-count carton, Rx only, manufactured by Mylan Pharmaceuticals Inc., Morgantown, WV 26505, NDC: Lot # , Exp. 7/2016 I Failed impurities/ degradation specifications: Out of specification result for known impurity at sixmonth time point. Mylan Institutional Inc. (d.b.a. UDL) Voluntary national recall Posted April 5, 2016 B. Braun Medical Inc. recently identified an adverse quality trend in customer complaints for 5 percent dextrose injection USP, reporting that some PAB containers in lot J5J706 exhibited leakage and, in a few instances, visible particulate matter identified to be microbial growth. To date, all failures have been identified before the use of the product and there have been no reports of adverse events associated with this issue. 4

7 Pharmacy information To ensure timely communication from PerformRx, please make sure all of your pharmacy information such as phone number, address and hours of operation are accurate and up to date with the National Council for Prescription Drug Programs (NCPDP). Did you know? CMS published a list of Bin/PCN data for CMS posted an updated Labeler Code file. You can find more details at PrescriptionDrugCovGenIn/Pharma.html. Pharmacy issues Ever wonder why, when processing a claim, an error message of non-match pharmacy displays? How you can become contracted? How you can find out if your claims are being paid correctly? Where to send requested signature logs? You have questions, we have the answers. Pharmacy Network contact information Credentialing Fax: PharmacyNetworkCredentials@performrx.com Contracting Fax: PharmacyNetworkContracting@performrx.com Pharmacy Audit Fax: PharmacyAudit@performrx.com All other network requests Fax: PharmacyNetwork@performrx.com 5 PRX-16205