Compensation medicaid

The concept of a "secure" prescription form was expanded by the federal government in 2008 to all prescriptions written for Medicaid patients. Any prescription for a Medicaid patient must be written on a security form if the pharmacist is to be compensated for the prescription service. In turn, the use of "triplicate" prescription forms was eliminated and replaced with an online electronic transmission system whereby orders for Schedule II and Schedule III prescriptions are transmitted to a company that acts as a repository for these transactions. In California, it is called the CURES program (Controlled Substances Utilization Review and Evaluation System). Additional information about CURES may be found at http //ag. ca. gov/bne/tri ps. ph p. 

Medicaid is supervised by CMS but is administered by each individual state. In Medicaid, each state determines the list of health care professionals who can be considered as providers. For pharmacists to be considered providers of patient care services for Medicaid, the state can develop a Medicaid demonstration project (Snella, 1999). One example of a demonstration project is the Mississippi Medicaid project in which pharmacists were compensated for services such as asthma, diabetes, and hyperlipidemia management (Anonymous, 1998 Landis, 1998). 

Once the value-added service has been designed, fees established, and the method(s) for compensation selected, the pharmacist must learn how to submit claims. When providers submit claims to Medicare, Medicaid, or any other third-party payers, the claim typically is submitted on the CMS Form 1500. One exception to this is the hospital outpatient clinic, which uses CMS Form 1450. On CMS Form 1500, information regarding the submitting entity, referring physician, type of services offered, and related health condition is included. To convey this type of information, CPT codes and ICD-9-CM codes are used. These coding systems provide detailed information regarding the types of services provided and the specific health condition in a numerical format. Example CMS 1500 and 1450 forms are available on the CMS Web site (www.CMS.hhs.gov). 

Individual demand for traffic safety partly depends on avoiding the payment of medical expenses which will result from a traffic accident. While some outlay of money and time can be expected with each accident the outlay may be less than the total accident-related medical expense because of community-rated health insurance premiums or public assistance-related third party financing such as Medicaid and Medicare. The potential shift of some medical costs to those not involved in an accident means that individual demand for traffic safety tends to be too low. Similarly the demand may be too low because of the lack of precise experience rating for automobile insurance and possibly incomplete compensation for damaged parties through the courts especially when time costs and death are involved. 

Finally, progressive activists could fashion a narrative that focuses on the social costs that irresponsible products and activities impose on all citizens. To the extent that companies harm others without compensating them for their losses, the rest of us pick up the tab in increased insurance premiums and in taxes invested in Medicare and Medicaid. A social costs narrative should resonate fairly robustly in a declining economy characterized by large budget deficits and few new taxes. 

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