Annual Prescription Volume Attestation Resources
The purpose of this Annual Prescription Volume Attestation Resources page is to provide you with explanations, clarifications, and resources. The prescription volume attestation survey is now available until Friday, February 7, 2025.
Who attests?
Providers who submit claims to ForwardHealth with National Drug Codes are required to attest (that is, to affirm, show, or state something to be true) to their annual prescription volume. This requirement does not apply to federally qualified health centers, or out-of-state providers.
How do providers attest?
Complete the annual prescription volume attestation survey available to providers on behalf of the Wisconsin Department of Health Services by Mercer, a health care consulting firm, until Friday, February 7, 2025. Providers must complete the survey for all prescriptions dispensed, not just Medicaid prescriptions.
Organizations with multiple locations will be required to attest for each location individually.
Providers can submit surveys using a web-based tool or an Excel spreadsheet. The Excel format lets providers submit a single survey document for multiple locations; the web-based tool does not.
Survey Instructions
The Prescription Volume Attestation Survey Instructions provide guidance about completing the web-based survey and the Excel survey.
Web-Based Survey
Providers may access the online survey by:
Excel Survey
Providers can download and complete the Excel survey. Completed Excel surveys should be emailed to CODSurvey@mercer.com or faxed to 212-948-0047 to the attention of Kerri Wade.
What happens next?
ForwardHealth will use the 2025 attestation survey to assign the appropriate professional dispensing fee reimbursement rate for each provider, effective for dates of service (DOS) on and after April 1, 2025. ForwardHealth will notify providers of their rate assignments in March 2025.
If a provider does not submit a survey by Friday, February 7, 2025, ForwardHealth will assign that provider the lowest professional dispensing fee reimbursement rate.
Professional dispensing fee reimbursement rates for DOS before April 1, 2025, will not be impacted by the 2025 prescription volume attestation survey.
Why is this necessary?
The Centers for Medicare & Medicaid Services published the federal Covered Outpatient Drugs Final Rule (CMS-2345-FC) in January 2016 to address the rise in prescription drug costs by ensuring that Medicaid programs reformed payment methodologies for prescription drugs and drug rebates to accurately reflect market prices.
In accordance with the federal rule, ForwardHealth revised its pharmacy reimbursement policy, including implementing a professional dispensing fee reimbursement rate structure based on a provider’s annual prescription volume, effective for DOS on and after April 1, 2017.
Resources
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