• May 28, 2014
    This week CMS released the final regulation addressing changes in the Medicare Part D Prescription Drug Program. The most beneficial change for pharmacy was found in Section 18: Prescription Drug Pricing Standards and Maximum Allowable Cost that will require the maximum allowable cost prices of drugs be updated at least every 7 days and disclosed in advance of their use. The MAC implementation requirements will be effective January 2016.
  • Apr 30, 2014
    The Health Insurance Portability and Accountability Act (HIPAA) Security Rule requires that covered entities conduct a risk assessment of their healthcare organization. A risk assessment helps your organization ensure it is compliant with HIPAA’s administrative, physical, and technical safeguards. A risk assessment also helps reveal areas where your organization’s protected health information (PHI) could be at risk.
  • Apr 16, 2014
    The proposed Medicare regulation was not part of the Affordable Care Act, but the controversy over the law meant that the Administration didn’t want another healthcare related fight. Most of the opposition to the proposed rule came from patients, physicians and drug companies concerned with the proposed changes to three protected drug classes. However, there was also significant opposition from pharmacy benefit managers (PBMs) and insurance companies specific to the proposed elimination of preferred networks.
  • Dec 03, 2013
    In late November, The Centers for Medicare & Medicaid Services (CMS) announced its intention to finalize the Federal Upper Limits (FUL) for multiple source drugs beginning in July 2014. CMS believes the delay will allow states to better design drug reimbursement strategies for pharmacies.
  • Dec 03, 2013
    Beginning January 1st, 2014 Medicare Advantage and PDP Plans must check with beneficiaries before prescriptions are delivered to the home. The Medicare plans won’t be allowed to automatically ship refills unless they confirm that the patient has verified that they still want the order.
  • Sep 05, 2013
    IPC Member Special on PRS Solution The Health Information Technology for Economic and Clinical Health Act (HITECH) strengthens HIPAA's enforcement provisions and increases the penalties for HIPAA and HITECH violations. According to the law, ignorance is no excuse for not adhering to HITECH standards. The Act calls for random periodic audits of all HIPAA-covered entities and their associates and contractors. Businesses not in compliance may face penalties ranging from $10,000-$50,000 per violation for willful neglect.