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Pharmaceutical Services Negotiating Committee

Drug Tariff News

Change in how the prescription bundle rechecking system operates

The NHS Business Services Authority (NHS BSA) has advised that there have been some changes in the way in which its prescription pricing rechecking system for English pharmacy contractors will operate.

The changes were outlined in Part XIVB of the Drug Tariff from 1st January 2013.

Under the CIP error package agreed for the financial year 2011-12, contractors had until 31st December 2012 to requests checks on the pricing of prescriptions dated April 2011 to March 2012. Now that this request period has ended, any subsequent prescription bundle recheck requests (i.e. for prescriptions dated April 2012 or later) must be submitted on a new form and the time allowed to submit requests for rechecks has increased to 18 months after dispensing.

To request a recheck from NHS BSA, contractors must:

  • Use the appropriate form available from NHS BSA (you can find this at http://tinyurl.com/rxrecheckform).
  • Submit their request within 18 months from the end of the dispensing month being requested (e.g. for prescriptions dispensed in April 2012, a contractor must submit their request for a check by 31 October 2013).
  • Complete a separate form for each month being requested for a recheck. Contractors with more than one pharmacy need to complete separate request forms for each pharmacy and month they wish to have checked.

Pharmacy contractors should be aware that where they have requested rechecks of one or more complete monthly bundles, the NHS BSA has advised that it will select an equivalent number of additional months to check to ensure that adjustments made fairly reflect both underpayments and overpayments.

  • Where a net underpayment is revealed for all months checked, the contractor will be paid the value of the underpayment;
  • Where a net overpayment is revealed, the NHS BSA will recover the value of the overpayment.

Once the 18-month deadline for requesting a check has passed (e.g. 31 October 2013 for prescriptions dispensed in April 2012), no further requests can be made for that particular dispensing month.

Frequently Asked Questions

1. Does the new form need to be completed for all recheck requests?

Yes, this will affect any type of recheck request – full bundle, expensive item, red separator, switching, etc. All contractors will be asked to complete a written request for any type of recheck so that there is a full audit trail of requests received.

However, the NHS BSA has confirmed that anything other than a full bundle recheck will not require an equivalent number of additional months to be checked.

PSNC has highlighted that the current form asks contractors to sign a declaration allowing subsequent months to be rechecked regardless of the type of check requested. NHS BSA has confirmed that the recheck request form will be updated to more clearly reflect the type of check requested and, for now, contractors should use the current form but state the type of check they wish to have (e.g. “red separator check”) in the ‘additional information’ box.

2. Why have these changes been brought in?

These are policy changes that have been introduced by NHS BSA as part of their efforts to formalise the rechecking process and ensure that there is a full audit trail of requests received.

3. Will there be a CIP error package for 2012-13?

Since 2009, PSNC has secured recognition for contractors of ongoing problems with prescription pricing accuracy. There has also recently been a considerable investment by PSNC in a new electronic auditing system which is enabling better independent auditing of contractors’ accounts and also helps to inform work carried out with the NHS BSA to improve pricing accuracy. PSNC will continue to push for improvement in pricing accuracy and for recognition of the problems faced by contractors, but cannot as yet confirm any arrangements for a CIP error package for 2012-13. 

Posted 21 February 2013

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