Insights & Analysis
Practical guidance on PBM audits, federal investigations, compounding defense, DEA enforcement, telehealth compliance, and the regulatory pressures facing pharmacies and providers nationwide.
More articles — Page 74
Page 74 of 115 · 1039 articles
Office Use Compounding: The State-by-State Problem
Section 503A requires a patient-specific prescription for compounded drugs, but state boards of pharmacy diverge sharply on office…
Physical Security Requirements for Controlled Substances
DEA's physical security rules for controlled substances set different storage, screening, and reporting duties for pharmacies than…
PDMP Obligations and Enforcement
State PDMP check-and-report mandates create a dispensing record. DEA and state boards use that record as evidence in diversion inv…
Prescriber Verification Findings and How to Cure Them
When a PBM cannot verify a prescriber, the claim can trigger recoupment. Here is how pharmacies document and cure these audit find…
Pharmacy Credentialing Denials and Re-Credentialing Traps
PBM credentialing denials and re-credentialing rejections can cascade into terminations across every network a pharmacy depends on…
Reinstatement After Medicaid Exclusion
Completing a Medicaid exclusion period does not restore eligibility. Covers OIG reinstatement timing, application standards, and s…
Personal Care Services Medicaid Audits
How state Medicaid auditors use EVV records, attendant timesheets, and aide qualification files to build personal care services ov…
Taking a Medicare Overpayment to Federal Court
Providers must exhaust five levels of Medicare appeal before federal court review, then face a strict deadline and a narrow standa…
Signature Requirements in Medicare Documentation
How CMS defines a valid Medicare signature, when a signature log or attestation statement can fix a missing or illegible one, and…