Tips and Tricks: Revitas Medicaid Rebates Module – Managing Updates from CMS Release #91
Revitas Medicaid Rebates manages rebate calculations and invoice processing to support the federal Medicaid Drug Rebate Program (MDRP), as well as other state supplemental and state pharmaceutical assistance programs (SPAPs).
In September 2014, CMS sent release #91 to pharmaceutical manufacturers, stating that in situations where an invoice includes a product after its expiration date (i.e., more than four quarters after the product is terminated), but the units were dispensed prior to the product’s termination date, the manufacturer must pay rebates on the expired product using the RPU from the last valid quarter for that product. Revitas Medicaid Rebates has been updated to meet this new CMS requirement.
1. Learn how to override errors on invoices for products that have expired prior to the invoice quarter.
2. Learn how valid claims are created for the overridden invoice items using the RPU from the product’s expiration quarter.
3. Learn how overridden items are processed as valid items in the system all the way through to payment.
4. Learn how to identify overridden items on various reports in Medicaid Rebates.