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Full Activation of Pharmacy, Non-Pharmacy OPR Edits and Rescheduling of Hydrocodone Combination Products

Full Activation of OPR Edits: Resident Temporary Deferment Ending:

The primary purpose of this bulletin is to announce that the resident deferment is ending. Effective October 1, 2014, OPR edits will set if the ordering, referring, or prescribing is not enrolled in CMAP; submission of a Student/Resident taxonomy will no longer enable claims to bypass OPR requirements unless the resident is enrolled in CMAP.

Effective October 1, 2014, pharmacy and compound claims received without the NPI of an enrolled hospital resident or physician will deny and post Explanations of Benefit (EOB) 0207 'Prescribing provider not enrolled'.

Rescheduling of Hydrocodone Combination Products:

The U. S. Drug Enforcement Administration (DEA) has published in the Federal Register the Final Rule moving hydrocodone combination products (HCPs) from Schedule III to the more restrictive Schedule II, as recommended by the Assistant Secretary for Health of the U.S. Department of Health and Human Services and as supported by the DEA's own evaluation of relevant data.

Please click here to access the update in PDF form.

News & Updates > Details