Audit Risk: Ivermectin Used for Treating COVID-19

From PAAS National website: Despite recent warnings from the Centers for Disease Control and Prevention and the U.S. Food & Drug Administration, there has been a 24-fold increase recently in the number of outpatient prescriptions for ivermectin compared to the pre-pandemic baseline.

Consequently, PAAS National is seeing more PBM audits on ivermectin prescriptions. Pharmacies should be prepared to have claims looked at for potential recoupment on the basis of “clinical appropriateness.” Pharmacists should give extra scrutiny to telemedicine providers who may not have a valid patient-provider relationship, by prescribing outside their scope of practice or not licensed in the state where the patient lives.
PAAS Audit Assistance members can view the July 2021 article, Audit Risk: Ivermectin Used for Treating COVID-19 on portal.paasnational.com

Prescriptions successfully processed at point-of-sale do not guarantee payment. PBMs and payers use pay and chase methods to recoup claims to avoid inhibiting potentially needed access to medications. Prescriptions dispensed for cash may still carry risk outside the scope of PAAS audit services: While off-label prescribing is commonplace, what is atypical with ivermectin for COVID treatment is the FDA, CDC, NIH and national medical and pharmacy associations recommending against its utility. This seems to open the door for potential malpractice lawsuits.

Contact PAAS National at 608-873-1342 or info@paasnational.com to see why membership may be right for you.
Article by Trenton Thiede, PharmD, MBA, President at PAAS National.