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Medicare Part D prescriber prescription verification requests (NJ only)

September 28, 2012

As part of the ongoing effort to combat fraud, waste, and abuse in the Medicare Part D program, the Centers for Medicare & Medicaid Services has engaged NBI MEDIC (Health Integrity LLC), in an outreach effort to request that prescribing physicians verify prescriptions during the course of an investigation. When investigating a potential prescription drug fraud and abuse situation, a key element includes prescriber prescription verification to confirm whether or not the physician actually wrote the prescription in question. NBI MEDIC routinely mails the prescribing physician a prescription verification form to be completed within two weeks. NBI MEDIC investigators report that no more than 5 to 10 percent of prescribers respond to these requests. If you are contacted by NBI MEDIC, it is imperative that you respond to their request for prescription verifications within two weeks. A timely and complete response to prescription verification helps NBI MEDIC take appropriate action by confirming or eliminating an allegation of wrongdoing and/or preventing the payment for fraudulent prescriptions. For information on how AmeriHealth fights fraud, waste, and abuse, visit the Anti-Fraud page on our website.

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