Pharmacy

Pharmacy Question for the Week of September 16, 2019

Pharmacy Compliance Question of the Week

Question:

What are some examples of when medications would not be reasonable and necessary according to accepted standards of medical practice?

Answer:

According to the Medicare Benefit Policy Manual, the following three criteria define when a medication is considered not reasonable:

  • Medications are given that are not for a particular illness
  • When the injection method is not indicated
  • Medications that exceed the frequency or duration of accepted standards of medical practices.