CDS WORKSHOP – CORRECTION

February 16, 2016

Please note the earlier post indicated registration was not required. This was stated in error. You must register with Mo Healthnet to attend the workshops. Registration may be completed by email.  Instructions for workshop registration are available on the MHD website at https://dss.mo.gov/mhd/providers/pdf/workshops.pdf

 

CDS WORKSHOP

February 16, 2016

Consumer Directed Services (CDS) vendors are invited to attend a workshop coordinated  by Missouri Medicaid Audit and Compliance (MMAC) in conjunction with the MO HealthNet Division (MHD).  Presenters from MHD and the Department of Health and Senior Services (DHSS) will provide information on the Web Tool and proper billing procedures.  Professionals from the provider community will present information on case management.

 

The workshop is designed for CDS billers and managers.  MMAC currently conducts Designated Manager workshops for In-Home Services providers, and designed this workshop in response to requests for more CDS-related information.  The class will address “every day” questions, and CDS vendors assisted the agencies in planning and designing the agenda.

 

Registration is not required.  However, you may register by clicking here.  Once you arrive at the website, choose “MO HealthNet Training Workshops” and sign up for the Consumer Directed Services (CDS)  presentation, scheduled for March 28, 2016.  There is also a workshop for In-Home services (personal care, homemaker, and respite) scheduled for the afternoon of March 28.

PRESCRIPTION FRAUD ALERT

February 16, 2016

Missouri Medicaid Audit and Compliance (MMAC) has seen a recent increase in fraudulent prescriptions passed across Missouri. The prescriptions contain similarities, listed below, and illustrated in a sample template.

(click here to view the template)

 

Common characteristics of the fraudulent prescriptions:

 

St. Louis area prescribers Prescriptions are usually written for Oxycodone-Acetaminophen 10-325 for quantities of 120-180 tablets Patient addresses are invalid. The invalid street addresses are usually in the same city as the pharmacy where the prescriptions are presented Prescriptions usually presented to the pharmacy after the doctors’ offices have closed Some were presented on tamper-resistant paper.

 

Unless an exception exists, MO HealthNet prescriptions must be written on tamper-resistant paper. (Exceptions include prescriptions reimbursed by a MO HealthNet managed care entity, prescriptions provided in certain facilities such as nursing facilities and hospitals, and prescriptions faxed, telephoned, or e-prescribed.) As a reminder, to be compliant with this requirement, a prescription pad must contain the following characteristics:

 

An industry-recognized feature designed to prevent unauthorized copying of a completed or blank prescription form (such as a high security watermark on the reverse of the blank or the use of thermochromic ink) An industry-recognized feature designed to prevent erasure or modification of information written on the prescription by the prescriber (such as tamper-resistant background ink that shows erasures or attempts to change written information) An industry-recognized feature designed to prevent the use of counterfeit prescription forms (such as sequentially numbered blanks or duplicate or triplicate blanks)As noted above, some of the fraudulent prescriptions were presented on tamper-resistant paper, , highlighting the need to check for all three required features.If you suspect prescription fraud regarding a Medicaid participant, please contact MMAC.LOCKIN@dss.mo.gov or call (573) 751-3399). As well, if you suspect any person is breaking the law in your pharmacy, contact local law enforcement.

 

If you have any questions, please contact MMAC at MMAC.REPORTFRAUD@dss.mo.gov