Covered Outpatient Drug Pricing

Welcome » April 26, 2024 9:09 PM

	Alerts
	Change Healthcare (CHC) has begun submitting some batch X12 electronic transactions to ForwardHealth. The volume of backlogged claims held by CHC and the amount of time it will take CHC to send them is unknown. ForwardHealth will process them in the order received. Visit the Change Healthcare Service Interruption: Resources page for more information on the security incident and for ForwardHealth resources. Multi-factor authentication (MFA) is now required for the secure ForwardHealth Portal. Providers are encouraged to refer to the ForwardHealth Multi-Factor Authorization Instruction Sheet for help setting up MFA preferences. Providers may contact their Portal account administrator or call the ForwardHealth Portal Help Desk at 866-908-1363. Note: This is a project-specific announcement and is not related to the Change Healthcare disruption.

Prescription Volume Attestation Survey

As a result of the data collected through the June 2016 Professional Dispensing Fee Survey, a tiered professional dispensing fee structure was implemented based on total annual prescription volume. To determine each dispensing provider's annual prescription volume (for all prescriptions dispensed, not just Medicaid prescriptions), ForwardHealth contracted with a health care consulting firm, Mercer, to conduct a mandatory Prescription Volume Attestation Survey.

ForwardHealth used the reported annual prescription volume to assign the appropriate professional dispensing fee reimbursement rate for each provider for dates of service on and after April 1, 2017. Providers were notified of their assigned professional dispensing fee reimbursement rate in a March 2017 communication.

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Wisconsin Department of Health Services

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