Express Scripts, Inc. has recently adopted new credentialing processes for compounding pharmacies that differ markedly from pharmacies’ previous recredentialing format. Citing increased risk of fraud related to the dispensing of compounding prescriptions, Express Scripts has adopted new terms and conditions for compounders, and has implemented a new enhanced online credentialing process for all compounding pharmacies. If a pharmacy meets the new enhanced terms and conditions, the pharmacy will receive a new compound-specific, contract amendment that will form the basis of a new, compounding network (through which a pharmacy must participate if it seeks to bill for compounds). The enhanced recredentialing form asks very detailed questions regarding a pharmacy’s practices and requires the submission of much more documentation to demonstrate compliance with laws, regulations and the updated 2014 Manual.
Within three days of receiving an initial letter from Express Scripts, compounding pharmacies will receive an email invitation to a website to complete the online recredentialing form, and will be required to pay a $1,000 non-refundable application fee. Express Scripts intends to roll this out in phases among different groups of pharmacies, until it ultimately has a single compounding network. Even if you haven’t yet received a letter, compounding pharmacies must be prepared because they only have 20 days to complete the online application.
Frier Levitt can assist pharmacies in completing this very robust application and can advise clients on compliance with the updated Manual as well as State and Federal laws and regulations. Frier Levitt can help your pharmacy navigate this important application process for a flat fee, affording a substantial savings off our hourly rates. If you’ve received a compounding-specific recredentialing request, contact Frier Levitt.
