Blog

»  Posts By   July 2012 

Prime Therapeutics May Not Be Reimbursing Compounders for All Ingredients Since Transition to D.0

Has your reimbursement for compounds been drastically reduced by Prime Therapeutics following the transition from NCPDP 5.1 to D.0? Prime requires pharmacies to submit all compound ingredients at the point-of-sale (“POS”). Prime does not usually “reject” the ingredients identified at the POS. This may create the false impression that Prime has “accepted” and agreed to reimburse for such ingredients. However, Prime has not been paying compounders for all of the...

Alaska Medicaid Settles HIPAA Security Case for $1,700,000

Alaska's State Medicaid agency (the “Agency”), has agreed to pay the U.S. Department of Health and Human Services’ (“HHS”) $1,700,000 to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).  Alaska has also agreed to take corrective action to properly safeguard the electronic protected health information (“ePHI”). The HHS Office for Civil Rights (“OCR”) began its investigation following a breach of ePHI. The breach was...

Recent Walgreens Settlement of False Claims Act Violations Highlights the Effectiveness of Qui Tam Actions

Late last month, the United States Department of Justice announced that Walgreens Pharmacy had agreed to pay $7.9 million to settle allegations that Walgreens had violated the Federal False Claims Act. In a suit brought as a qui tam action by a pharmacy technician and an independent pharmacist, the government contended that Walgreens’ program of offering $25 gift cards to patients when they transferred a prescription from another pharmacy constituted...