Navigation Links
New CSS program helps PartD sponsors meet CMS drug overutilization requirements

BUFFALO, N.Y., June 20, 2012 /PRNewswire/ -- Those working in Medicare programs have full schedules, filled with program submission rules, standardized formats, policy changes, data validation audits, on-site audits and more. Just when it seems there aren't enough hours in the day to get it all done, the Centers for Medicare & Medicaid Services (CMS) is adding even more oversight by getting tough on prescription overutilization by Medicare beneficiaries, and Clinical Support Services, Inc. (CSS) has a new program to help identify and track those most at risk.

CSS's new program helps Medicare plans offering prescription coverage to meet CMS's new requirements for retrospective drug utilization review by identifying "patterns which suggest that the identified patients may be at risk of overutilization. Part D sponsors should create and monitor Part D utilization reports to identify patterns of apparent duplicative drug use over sustained periods of time and/or across multiple drug products," according to the CY2013 Final Call Letter.

CSS's program reviews pharmacy claims and plan eligibility data monthly, then flags patients of concern by using predetermined selection criteria such as number of prescriptions filled in a 30-day period for frequently abused drug classes; number of physicians prescribing medication for that patient; and number of pharmacies filling prescriptions for that patient. Medicare plans receive a data report to determine the best course of action for that patient.

"Medicare plans have had even more responsibility thrust upon them," said James Notaro, RPh, Ph.D., CSS president. "This is a serious problem that needs serious consideration."

About CSS: Founded in 1999 by pharmacists and technologists, CSS is staffed by experienced clinicians, software developers and operations personnel who develop innovative and proprietary technology tools that improve patient care while providing financial value. At the heart of the business is Medication Pathfinder™ – built in a S-O-A-P (Subjective-Objective Assessment Plan) Note structure to help pharmacists move more quickly through complex patient Medication Therapy Management (MTM) assessment procedures. Structured data storage is one of the main differentiating features of the MTMPath system. Additional CSS software solutions include iDealTherapy™ and Star Ratings Booster™.

Cheryl Krajna
Clinical Support Services, Inc.
(716) 541-0273

Available Topic Expert(s): For information on the listed expert(s), click appropriate link.
James Notaro, RPh, Ph.D.

SOURCE Clinical Support Services, Inc.
Copyright©2012 PR Newswire.
All rights reserved

Related medicine technology :

1. Accuray Rolls Out Comprehensive Customer Service Program in Japan
2. Lilly Declares Third-Quarter 2012 Dividend, Resumes Share Repurchase Program
3. Effectiveness of Medicare Authorization Program for Power Wheelchairs Rests on Inclusion of a Clinical Template
4. Daniel Sontupe, SVP, Director of Market Access, at The CementBloc, to Present on Uncovering the Value in a Patient Support Program at CBI Summit
5. Delcath To Offer Second Generation Hemofiltration Cartridge In U.S. Expanded Access Program
6. Chinese Compulsory Immunization Program for Livestock Creates Massive Opportunity for Animal Vaccines and Biologics Developers
7. American Medical Systems and Allergan Sign Agreement for JetTouch™/BOTOX® Co-Development Program
8. The Galien Foundation Announces New "Best Medical Technology" Award Category for 2012 Prix Galien USA Awards Program
9. Pennsylvania DEP Announces X-ray Registration Fee Amnesty Program
10. Liberty Dialysis Celebrates Milestone 1,000th Patient in Peritoneal Dialysis Program
11. Rigel Advances Asthma Programs: Two Inhaled Drug Candidates Take Aim at Acute and Chronic Lung Disease
Post Your Comments:
(Date:10/10/2017)... Calif. , Oct. 10, 2017  NDS received FDA 510(k) ... — a medical-grade battery-powered display stand specifically designed for endoscopy environments. ... transform technology into a clinical solution to support the improvement of ... Innovative Design ... Mobile Wireless Solution ...
(Date:10/4/2017)... , Oct. 4, 2017  According to the Centers for Disease Control ... of October . PhysicianOne Urgent Care is helping communities across ... NY , by offering no-cost* flu shots through the end of ... by certain health insurance regulations. ... best time to get a flu shot is by the end of ...
(Date:10/2/2017)... Halo Labs announces the European launch of their new low volume, ... 2017 in Cambridge, U.K on October 4th. ... samples with unprecedented speed and sensitivity while using far less sample ... ... system ...
Breaking Medicine Technology:
(Date:10/13/2017)... ... October 13, 2017 , ... ... communities in the greater Dallas, Miami, and Raleigh regions, is organizing an extended ... overcome a rare and deadly chromosome abnormality. , After struggling since birth with ...
(Date:10/13/2017)... ... October 13, 2017 , ... The ... to promote standards of excellence for the field of eating disorders, announces the ... – 25, 2018 in Orlando, Florida at the Omni Resort at ChampionsGate. ...
(Date:10/13/2017)... SAN LUIS OBISPO, Calif. (PRWEB) , ... October 13, 2017 , ... ... with Alzheimer’s or dementia. However, many long-term care insurance companies have a waiver for ... mean is the 90-day elimination period, when the family pays for care, is often ...
(Date:10/13/2017)... (PRWEB) , ... October 13, 2017 , ... ... will be giving viewers the lowdown on sciatica in a new episode of ... that focuses on current events and innovation and investigates each subject in-depth with ...
(Date:10/12/2017)... San Francisco, CA (PRWEB) , ... October 12, ... ... and Dr. Cheng, are now treating sleep apnea using cutting-edge Oventus ... sleep apnea, a serious sleep disorder characterized by frequent cessation in breathing. Oral ...
Breaking Medicine News(10 mins):