BACKGROUND:
Pharmacies across the U.S. are facing intense pressure to maintain accurate prescriber data for prescription adjudication, including Part D drug plan prescriptions. With billions of dollars paid in prescription reimbursements every year, the Centersfor Medicare and Medicaid Services (CMS) has bolstered its oversight activities in order to maintain program integrity and minimize fraud, waste
and abuse. The legislative mandate to validate prescriber data at the point of sale presents tremendous challenges to pharmacies,
however. To remain in compliance, pharmacies, regardless of size, must bring their prescriber validation systems up to real
time speed or risk the possibility of expensive fines, time consuming audits and rejected reimbursements.
White paper published by Healthcare Data Solutions
