72-Hour Supply of Emergency Medication
I
n the most recent Department
of Health Care Services
(DHCS) audit of the Alliance,
a finding was identified on
monitoring for the provision of
prescribed drugs in emergency
departments (EDs). In order to
verify ongoing compliance with
this vital service to our members,
and in lieu of performing
additional ED access audits,
the Alliance is requesting that
our network of hospital EDs
annually submit a copy of
policies and procedures and
an attestation regarding the
dispensing of medications to
patients in emergency situations.
The Alliance maintains current
policies submitted by contracted
medical centers to verify after-hours
availability of prescription
medications. A letter and
attestation form will soon be sent
to each ED requesting a signature
by the hospital’s ED Director or a
representative with the knowledge
and authority to guarantee
compliance with this contractual
obligation.
This requirement can be met by
providing a 72-hour supply of the
drug to the member, or provision
of an initial dose of medication
and a prescription for additional
medication, which together cover
the member for the 72-hour
period. The hospital’s policies
and procedures should describe
the methods used for ensuring
compliance with the 72-hour
requirement.
If you have any questions,
please call Britta Vigurs, Quality
Improvement Administrative
Assistant, at
(831) 430-2620
.
●●
Your CA Medical Board license
number.
●●
Managed Care Plan: As a
contracted Alliance provider
please use relevant codes from the
following:
– Santa Cruz County 505
– Monterey County 508
– Merced County 514
●●
Your ABMS, ABPS or AOA
certification, beginning and end date.
●●
If applicable, information for
staff you directly supervise who bill
Medi-Cal independently.
When:
Don’t delay. The link is
active and available now.
Please note:
This attestation
process is different and separate
from the Medicare meaningful use
attestation process.
Ensure You Are Eligible for Enhanced Payment
Quick & Easy ACA California Provider Attestation Process
What:
State Medicaid agencies
are required to reimburse PCPs with
a specialty designation at parity with
Medicare for specified Evaluation
and Management (E&M) and
Vaccine Administration services.
Who:
PCPs with a specialty
designation of Family Medicine,
General Practice, Internal
Medicine, or Pediatric Medicine
and/or subspecialty designations as
identified. See attestation form for
details.
Why:
In order to be eligible for
enhanced payment, the physician
rendering or supervising the service
must personally attest.
Where and how:
The State
Attestation is also accepted by the
Alliance and is available at
o
complete your attestation you will
need to provide the following:
●●
Your NPI and TIN.
●●
Your email address.
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PROVIDER NEWS
