Medicare Part B Pharmacy Compliance Program

Medicare Part B Pharmacy Compliance

In the fiscal year 2018, Medicare’s Recover Audit Contractors (RAC) collected over $8 billion in DMEPOS overpayments.  In most cases, these overpayments resulted from supplies not having the proper medical necessity documentation to validate medical necessity based on the Medicare Local Coverage Determinations (LCD) and Policy Articles (PA).

The MEDBTrack Program is designed to help those Pharmacies exempt from the Medicare DMEPOS accreditation requirements and those Pharmacies that are only billing Medicare Part B for Drugs and Biologicals (e.g., inhalation solutions, immunosuppressants, and antiemetic medications).  The Program provides an easy-to-follow set of policies, procedures, forms, and training to comply with the Medicare DMEPOS Supplier Standards and the Medicare Part B Documentation requirements.

The PRS MEDBTrack Program is easy to use and comprehensive.

The program includes:

• Access to PRS specialists for Medicare Documentation and Audit Questions
• Up-to-date Policies and Procedures to comply with the Medicare DMEPOS Supplier Standards and Medicare DMEPOS Documentation Requirements
• General Medicare DMEPOS education, including information on Medicare Enrollment and Local Coverage Determinations, Medicare Contractors and links to other resources
• Ongoing training for your employees to help ensure they understand the Medicare Part B Pharmacy Compliance requirements