Table 2: Assessment Question Yes No N/A Unsure For each prescription tested in Table 2, is Medicaid billed according to state requirements? Answer if all contract pharmacy locations carve out. “N/A” Answer to the question only if all answers are in the column titled “Yes” “Yes” entity /state Medicaid carve-in practice matches documented “Covered arrangement on file with HRSA” in Table 2. If response or explain: (Identify and discuss each outlier) “No” “Unsure,”
Table 2: Assessment Question Yes No N/A Unsure For each prescription tested in Table 2, is Medicaid billed according to state requirements? Answer “N/A” if all contract pharmacy locations carve out. Answer “Yes” to the question only if all answers are “Yes” in the column titled “Covered entity /state Medicaid carve-in practice matches documented arrangement on file with HRSA” in Table 2. If response “No” or “Unsure,” explain: (Identify and discuss each outlier)
covered-entity-self-audit-contract-pharmacy-prevention-of-duplicate-discounts.docx