• 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.
  • Jul 26, 2013
    The new Health Insurance Portability and Accountability Act (HIPAA) patient privacy and data security provisions found in the Health Information Technology for Economic and Clinical Health Act (HITECH) include...
  • Jun 04, 2013
    Round 2 of the competitive bidding program and the national mail-order program will go into effect July 1, 2013. Additional information can be found at the Competitive Bid Implementation Contractor (CBIC) website:
  • Jun 04, 2013
    Retail pharmacies and mail order pharmacies must include a valid Patient Residence code on all Part D claims transactions; however if the patient residence is unknown, these pharmacies may default to a Patient Residence of 1 (Home). We expect that LTC pharmacies, home infusion pharmacies and specialty pharmacies, since they deliver to the patient residence, will know with precision the patient residence and, thus this information will be appropriately reported on PDEs associated with claims from these providers.