New drug knowledge helps Medicare Part D plan sponsors and claims processors efficiently comply with myriad drug coverage and participation rules
South San Francisco, CA – September 3, 2014 – First Databank (FDB), the leading provider of clinical drug knowledge that improves medication-related decisions and patient outcomes, today announced the release of the FDB Medicare Part D Module™. The new drug knowledge codifies several Centers for Medicare & Medicaid Services (CMS) coverage rules, enabling Part D plan sponsors—and their claims processors and pharmacy benefit managers (PBMs), pharmacy providers, physicians, long-term care organizations and other related entities—to more easily and consistently manage existing and new CMS rules, as well as determine which of these existing rules apply to new drugs that enter the market.
Extensive Medicare Part D program oversight from CMS, including current policies and frequent changes aimed at providing improved services to its beneficiaries, has intensified the need for FDB customers and other stakeholders to access information that enables them to efficiently and effectively manage coverage and participation rules. The content in the FDB Medicare Part D Module is intended to be integrated into the computer systems of those entities that prescribe covered drugs, dispense prescriptions, adjudicate the prescription drug claims, and report on various coverage and quality of care measurements designed for efficient implementation of the Medicare Part D program.
The FDB Medicare Part D Module provides National Drug Code (NDC)-level information for the following:
- Acetaminophen Quantity: Aids in the calculation of the maximum daily dose of acetaminophen to prevent accidental overdose.
- Morphine Equivalent Doses: Aids in the conversion and calculation of the total morphine equivalent dose for opioid-containing drug products. This assists in determining if the morphine daily quantity threshold is exceeded.
- Comprehensive NDC SPL Data Elements (NSDE) Information: Identifies drugs eligible for coverage under Medicare Part D using the following elements: NDC, Marketing Category, Marketing Start Date and Marketing End Date.
- Short Cycle Dispensing: Facilitates the identification of drugs that are subject to the 14-day dispensing rules for pharmacies providing services to long-term care facilities.
- Star Ratings: Provides medication listings that support CMS Medicare Part D quality of care initiatives and plan ratings.
“As Medicare Part D enrollment numbers continue to grow, so does the complexity of the regulations,” said Keith Fisher, RPh, market manager, FDB. “Our vision is to provide, in a single, convenient source, relevant information that plan providers need in order to keep pace with an ever-changing compliance environment. By using the FDB Medicare Part D Module to manage their Medicare Part D drug lists, our customers can enjoy peace of mind knowing they can focus their efforts on serving the needs of their patients and members.”
About First Databank (FDB)
FDB (First Databank), part of the Hearst Health network, is the leading provider of drug knowledge that helps healthcare professionals make precise medication-related decisions. With thousands of customers worldwide, FDB enables our information system developer partners to deliver a wide range of valuable, useful, and differentiated solutions. As the company that virtually launched the medication decision support category, we offer more than three decades of experience in transforming drug knowledge into actionable, targeted, and effective solutions that improve patient safety and healthcare outcomes. For a complete look at our solutions and services please visit http://www.fdbhealth.com or follow us on Twitter and LinkedIn.
About Hearst Health
FDB is part of the Hearst Health network, which also includes Zynx Health, MCG (formerly Milliman Care Guidelines) and Homecare Homebase. The mission of the Hearst Health network is to help guide the most important care moments by delivering vital information into the hands of everyone who touches a person’s health journey. Each year in the U.S., care guidance from the Hearst Health network reaches 76% of discharged patients, 133 million insured individuals, 20 million home health visits, 1.88 billion retail pharmacy prescriptions and 3.26 billion prescription claims. Extensions of the Hearst Health network include Hearst Health Ventures and the Hearst Health Innovation Lab.