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Physician Administered Drug and Vaccine Acquisition Cost Study FAQ
- What is the Physician Administered Drug and Vaccine Acquisition Cost Study?
A. The PAD & Vaccine Acquisition Cost Study is a tool which will be used to collect and analyze the cost to a provider to acquire drugs or vaccines that will later be administered to a Medi-Cal beneficiary and billed to Medi-Cal using the Healthcare Common Procedure Coding System (HCPCS) fee schedule.
- Why is the Department of Health Care Services (DHCS) conducting the study?
A. DHCS is conducting the study to comply with the provisions of California Welfare and Institutions (W&I) code section 14105.456, which requires the department to develop a new reimbursement methodology for drug or vaccine products billed to Medi-Cal using the HCPCS fee schedule. The department has contracted with Myers and Stauffer, LC to conduct the study.
- What is a Physician Administered Drug and Vaccine ?
A. For the purposes of this study, a physician administered drug is any drug or vaccine billed for reimbursement using the HCPCS fee schedule.
- Why is my practice being included in this survey?
A. Medi-Cal providers were selected to participate in this survey based on analysis of Medi-Cal HCPCS fee schedule administrative claims data. A representative stratified sample of Medi-Cal providers has been included in the study to facilitate the collection of sufficient information for the purposes of the evaluation.
- Why should my practice/business participate?
A. Your participation in the survey will ensure your acquisition costs are appropriately factored into the study evaluation and analysis.
- What do I need to submit to DHCS to comply with the study?
A. Submit all invoices for drug and vaccine purchases for the period of March 1, 2011 thru May 31, 2011. Complete and submit the Certification Statement which reports off-invoice discounts, credits and rebates for the products purchased on the invoices.
- What if my invoices show products other than physician administered drugs and vaccines?
A. Participants may submit all purchase invoices that without any additional editing or redaction. Myers and Stauffer, LC will only select invoice information that is relevant for the purposes of the study.
- What if my practice is an outpatient clinic attached to a hospital and sources drugs from the hospital?
A. If a survey participant does not maintain its own records for drug purchasing, it will need to request submission of those records from the parent institution or other entity in possession of the required documents.
- What if the business is a hospital with a large number invoices?
A. Myers and Stauffer, LC is adequately prepared to handle large volumes of invoice documentation. Providers may request wholesalers to submit invoices directly to Myers and Stauffer.
- What if my practice qualifies for 340B drug purchasing?
A. All Medi-Cal providers, including 340B providers, are included in the study. Covered Entities under the 340B drug purchasing program are required to identify themselves on the Certification Statement.
- What if my practice chooses not to respond?
A. Completion and submission of the survey is a requirement pursuant to California Welfare & Institutions code 14124.2 and the Medi-Cal provider agreement.
Failure to submit the requested information may result in suspension of your Provider Agreement.
- When is the next Informational Webinar?
A. An additional webinar to assist providers in completing the survey is tentatively scheduled for August 9, 2011. Information regarding an additional webinar will be mailed to study participants and be available on the Med-Cal website.
- What is the deadline for invoice submission?
A. The deadline for submission has been extended from July 29, 2011 to August 31, 2011. This one-time extension will provide an additional two week period for providers to comply with the study.
- Who do I contact if I have further questions?
A. For further information you may contact Myers and Stauffer, LC at 1-800-591-1183 or by email at email@example.com.
- How do I submit the required invoices to Myers and Stauffer, LC?
A. Invoices may be submitted via mail or email to:
Myers and Stauffer, LC
California PAD Study
9265 Counselors Row Ste. 200
Indianapolis, IN 46240
or by email to firstname.lastname@example.org
Please indicate “ California PAD Study” in the subject line.
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