As a result of the data collected through the June 2016 Professional Dispensing Fee Survey, a tiered professional dispensing fee structure was implemented based on total annual prescription volume. To determine each dispensing provider's annual prescription volume (for all prescriptions dispensed, not just Medicaid prescriptions), ForwardHealth contracted with a health care consulting firm, Mercer, to conduct a mandatory Prescription Volume Attestation Survey.
ForwardHealth used the reported annual prescription volume to assign the appropriate professional dispensing fee reimbursement rate for each provider for dates of service on and after April 1, 2017. Providers were notified of their assigned professional dispensing fee reimbursement rate in a March 2017 communication.
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