White Papers

    • Date Published
    • August 2019

    Controlled Substance - Quantity Prescribed White Paper

    The purpose of this white paper is to provide information and guidance on the use of the Quantity Prescribed (460-ET) field to address the Schedule II controlled substances (CII’s) billing issues identified in the September 2012 OIG report and to address issues with state requirements related to CII’s for dispensing of medication in increments less than the amount prescribed.

    • Date Published
    • June 2019

    Medicaid Drug Rebate Program-Challenges Across the Industry

    This white paper intends to educate interested parties regarding the general operational aspects of the Medicaid Drug Rebate Program (MDRP), provide a high-level description of the various end-to-end processes involved in the administration of the MDRP, identify challenges related to Medicaid drug rebate invoicing, billing quantity discrepancies, and the reconciliation between state Medicaid agencies and participating pharmaceutical manufacturers, offer recommendations for modifying processes with a focus on improved efficiencies for all parties involved in the administration of Medicaid rebate transactions and communicate key recommendations to the Centers for Medicare & Medicaid Services (CMS) MDRP Operations group with a goal of streamlining the process for all stakeholders.

    • Date Published
    • January 2019

    NCPDP Standards-based Facilitator Model for PDMP White Paper

    This latest update (2019) to NCPDP’s PDMP white paper outlines the latest changes in federal activity and industry impact to address the prescription drug abuse crisis. It explains how the new PDMP Reporting Standard and enhancements to the NCPDP SCRIPT Standard V2017071 and the Telecommunication Standard can facilitate standardization; real-time reporting of dispenser and purchaser data; and improve retrieval of PDMP data that will allow providers to make more informed clinical decisions at the point of care.

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