Annual Prescription Volume Attestation Resources
The purpose of this Annual Prescription Volume Attestation Resources page is to provide you with explanations, clarifications, and resources.
Who attests?
Providers who submit claims to ForwardHealth with National Drug Codes must attest (affirm, show, or state something to be true) to their annual prescription volume. This requirement does not apply to federally qualified health centers and out-of-state providers.
How do providers attest?
Providers can complete the annual prescription volume attestation survey starting in January 2026 on behalf of the Wisconsin Department of Health Services by Mercer, a health care consulting firm. Providers must complete the survey for all prescriptions dispensed, not just Medicaid prescriptions.
Organizations with multiple locations must attest for each location individually.
What happens next?
ForwardHealth will use the information from the 2026 attestation survey to assign the appropriate professional dispensing fee reimbursement rate based on the annual prescription volume for each provider. The new professional dispensing fee reimbursement rate assignments will be effective for dates of service (DOS) on and after April 1, 2026.
ForwardHealth will assign that provider the lowest professional dispensing fee reimbursement rate if a provider does not submit a survey by the requested due date.
Professional dispensing fee reimbursement rates for DOS before April 1, 2026, will not be impacted by the 2026 prescription volume attestation survey.
Why is this necessary?
The Centers for Medicare & Medicaid Services published the federal Covered Outpatient Drugs Final Rule (CMS-2345-FC) in January 2016 to address the rise in prescription drug costs by ensuring that Medicaid programs reformed payment methodologies for prescription drugs and drug rebates to accurately reflect market prices.
In accordance with the federal rule, ForwardHealth implemented a professional dispensing fee reimbursement rate structure based on a provider’s annual prescription volume, effective for DOS on and after April 1, 2017.
Resources
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