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CPE CONSULTANTS, LLC
 

Electronic Prior Authorization (ePA): Technology Advances and Emerging Legislative Requirements


Activity Overview
 
Prior authorization (PA) is a requirement that affects 186 million prescriptions per year. The process was implemented to provide the most appropriate and cost-effective health care services. It is prominent in community, specialty, Long Term Care (LTC), mail order and hospital pharmacy settings. The traditional PA process is complex and burdensome to health care providers and can delay or prevent patients from getting the medications they need.  The newly-adopted electronic prior authorization (ePA) standard reduces the burden of the traditional paper or phone-based PA process, improves first-fills, patient adherence and therapeutic outcomes, and prevents prescription abandonment. Electronic prior authorization can provide real-time submissions and determinations, dramatically improving patient access to needed medications.
 
 
 
NOTE:
This home study activity has been approved for 1.0 contact hour for both pharmacists and pharmacy technicians; the learning managment system automatically combines the contact hours for both professions when displaying the contact hours / CEUs below. 
 

Fee

$0.00

CE Hours

2.00

CE Units

0.200

Activity Type

  • Knowledge

Target Audience(s)

  • Pharmacists
  • Pharmacy Technicians

Accreditation(s)

CPE Consultants, LLC is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education
Accreditation Council for Pharmacy Education
 

Requirements for CE Credit

Registrants have the option of taking the pre-test for this activity or skipping the pre-test.  The ACPE provider encourages registrants to complete the pre-test before revieiwng the course material.  There is no passing score required on the pre-test and this test is simply used by the ACPE provider to determine both the baseline knowledge of each registrant and to asses the value of the continuing education activity by comparing pre and post-test results. 
 
Each registrant must review course material appropriate for their profession (please select either pharmacist or technician), successfully pass the activty post-test (scoring 80% or higher) and complete the online evaluation form.  Once the registrant has completed these requirements the continuing education credits will be uploaded automatically to CPE Monitor.  The registrant can also print out a hard copy of the statement of credit from their online continuing education account.
 
IMPORTANT: Pharmacy Education Credit. Your continuing education credits are uploaded to CPE monitor immediately after you have passed the post-test and completed your online program evaluation.  Please complete your evaluation immediately after passing the post-test.  If you fail to pass the post-test and/ or complete the online evaluation form within 30 days of registering for this activity your continuing education credits will not be uploaded to CPE Monitor and you will lose the credits. 
 
Please make sure that your eProfile number and date of birth are correct in your online profile. FAILURE TO COMPLETE CONTINUING EDUCATION ACTIVITY EVALUATIONS AND INCORRECT ePROFILE NUMBER AND / OR DATE OF BIRTH WILL RESULT IN LOSS OF CONTINUING EDUCATION CREDIT.
 
Thank you for your cooperation.

Support/Credits

Authors and Disclosures:  No one in a position to control the content of this activity has anything to disclose. All planners and developers of this activity have signed a disclosure statement indicating that they have no relevant financial interests.  The authors have fully disclosed they are employees of CoverMyMeds; bios and disclosures are included in the activity description below (+).
 
This activity is an overview of ePA.  It presents a balanced overview of ePA and does not include any mention or promotion of CoverMyMeds.  The activity content was reviewed by the provider's internal review staff and determined not to be biased.
 
The use of ePA is a method used to expedite the process of prescription filing. Since ePA is a process used to expedite prescription processing, in the judgement/assessment of the provider, the development of presentation content by the employees of CoverMyMeds does not violate ACPE standards approved to control commercial influence and to prevent any commercial entity involved in the manufacture or distribution of pharmaceuticals from using continuing education activities to promote and/or control the medical use of pharmaceuticals.
 
This activity was developed without commercial support.  An educational grant was provided by CoverMyMeds, LLC for the development of its content.

 

   

Activity Overview
 
Prior authorization (PA) is a requirement that affects 186 million prescriptions per year. The process was implemented to provide the most appropriate and cost-effective health care services. It is prominent in community, specialty, Long Term Care (LTC), mail order and hospital pharmacy settings. The traditional PA process is complex and burdensome to health care providers and can delay or prevent patients from getting the medications they need.  The newly-adopted electronic prior authorization (ePA) standard reduces the burden of the traditional paper or phone-based PA process, improves first-fills, patient adherence and therapeutic outcomes, and prevents prescription abandonment. Electronic prior authorization can provide real-time submissions and determinations, dramatically improving patient access to needed medications.
 

Objectives

  • Describe the end-to-end prior authorization workflow
  • Explain the electronic prescription drug prior authorization process and recall named standards
  • State current ePA Standards
  • Recall state legislation effecting prior authorizations
  • Explain prior authorization workflow to patients or caregivers

Speaker(s)/Author(s)

Dan Kelly picture

Dan Kelly, PharmD, co-author
Clinical Pharmacist, CoverMyMeds, LLC


Brief Bio : Dr. Kelly is a clinical pharmacist with CoverMyMeds, a healthcare IT company that develops software supporting the prior authorization process in pharmacy, prescriber, and EHR systems. He received his PharmD degree from Ohio State University in 2016, where he graduated with a 4.00 GPA. Dan was also a recipient of the Merck award as well as a member of Rho Chi Upsilon Honor Society.
Disclosure : Dan has disclosed the following relevant commercial financial relationships or affiliations in the past 12 months: employee - CoverMyMeds, LLC The relationship identified above is not associated with the content of this activity and will not be discussed or presented on any material.
Julie Hessick picture

Julie Hessick, RPh, co-author
Director of PBM/Plan Accounts, CoverMyMeds, LLC


Brief Bio : Julie Hessick is the Director, PBM/Plan Accounts at CoverMyMeds. She is responsible for account management and project management of all PBM and Plan clients. She oversees development, launch and on-going implementations for ePA and CoverMyMeds Central solutions. With over 15 years working in PBM, specialty, mail order and infusion services, Julie’s clinical experience helps CoverMyMeds build and maintain highly collaborative, long-term customer relationships. Before joining CoverMyMeds, Julie served as the Manager of Clinical Services and Manager of Pharmacy Operations PBM where she practiced clinical and administrative pharmacy in managed care, home infusion and specialty settings. She is a registered pharmacist in 16 states.
Disclosure : Julie has disclosed the following relevant commercial financial relationships or affiliations in the past 12 months: Employee – CoverMyMeds The relationship identified above is not associated with the content of this activity and will not be discussed or presented on any material.
Pamela A. Rowan picture

Pamela A. Rowan, PharmD, author
Clinical Pharmacist, CoverMyMeds, LLC


Brief Bio : Dr. Rowan is a clinical pharmacist with CoverMyMeds, a healthcare IT company that develops software supporting the prior authorization process in pharmacy, prescriber, and EHR systems. She received her PharmD degree from Ohio Northern University in 2006. She has worked in the managed care and PBM industry for 10 years; specializing in drug utilization review, quality assurance, and prior authorizations. She has also obtained a Cardiovascular Specialist Certificate from the University of Florida. Pamela is currently licensed to practice pharmacy in the state of Ohio
Disclosure : Pamela has disclosed the following relevant commercial financial relationships or affiliations in the past 12 months: Employee – CoverMyMeds The relationship identified above is not associated with the content of this activity and will not be discussed or presented on any material.

Activity Number

0864-0000-16-055-H04-P

Release Date: Jun 12, 2016
Credit Expiration Date: Jun 12, 2017

   

   

Activity Overview

Prior authorization (PA) is a requirement that affects 186 million prescriptions per year. The process was implemented to provide the most appropriate and cost-effective health care services. It is prominent in community, specialty, Long Term Care (LTC), mail order and hospital pharmacy settings. The traditional PA process is complex and burdensome to health care providers and can delay or prevent patients from getting the medications they need.  The newly-adopted electronic prior authorization (ePA) standard reduces the burden of the traditional paper or phone-based PA process, improves first-fills, patient adherence and therapeutic outcomes, and prevents prescription abandonment. Electronic prior authorization can provide real-time submissions and determinations, dramatically improving patient access to needed medications.


 

Objectives

  • Describe the end-to-end prior authorization workflow
  • Explain the electronic prescription drug prior authorization process and recall named standards
  • State current ePA Standards
  • Recall state legislation effecting prior authorizations
  • Explain prior authorization workflow to patients or caregivers

Speaker(s)/Author(s)

Dan Kelly picture

Dan Kelly, PharmD, co-author
Clinical Pharmacist, CoverMyMeds, LLC


Brief Bio : Dr. Kelly is a clinical pharmacist with CoverMyMeds, a healthcare IT company that develops software supporting the prior authorization process in pharmacy, prescriber, and EHR systems. He received his PharmD degree from Ohio State University in 2016, where he graduated with a 4.00 GPA. Dan was also a recipient of the Merck award as well as a member of Rho Chi Upsilon Honor Society.
Disclosure : Dan has disclosed the following relevant commercial financial relationships or affiliations in the past 12 months: employee - CoverMyMeds, LLC The relationship identified above is not associated with the content of this activity and will not be discussed or presented on any material.
Julie Hessick picture

Julie Hessick, RPh, co-author
Director of PBM/Plan Accounts, CoverMyMeds, LLC


Brief Bio : Julie Hessick is the Director, PBM/Plan Accounts at CoverMyMeds. She is responsible for account management and project management of all PBM and Plan clients. She oversees development, launch and on-going implementations for ePA and CoverMyMeds Central solutions. With over 15 years working in PBM, specialty, mail order and infusion services, Julie’s clinical experience helps CoverMyMeds build and maintain highly collaborative, long-term customer relationships. Before joining CoverMyMeds, Julie served as the Manager of Clinical Services and Manager of Pharmacy Operations PBM where she practiced clinical and administrative pharmacy in managed care, home infusion and specialty settings. She is a registered pharmacist in 16 states.
Disclosure : Julie has disclosed the following relevant commercial financial relationships or affiliations in the past 12 months: Employee – CoverMyMeds The relationship identified above is not associated with the content of this activity and will not be discussed or presented on any material.
Pamela A. Rowan picture

Pamela A. Rowan, PharmD, author
Clinical Pharmacist, CoverMyMeds, LLC


Brief Bio : Dr. Rowan is a clinical pharmacist with CoverMyMeds, a healthcare IT company that develops software supporting the prior authorization process in pharmacy, prescriber, and EHR systems. She received her PharmD degree from Ohio Northern University in 2006. She has worked in the managed care and PBM industry for 10 years; specializing in drug utilization review, quality assurance, and prior authorizations. She has also obtained a Cardiovascular Specialist Certificate from the University of Florida. Pamela is currently licensed to practice pharmacy in the state of Ohio
Disclosure : Pamela has disclosed the following relevant commercial financial relationships or affiliations in the past 12 months: Employee – CoverMyMeds The relationship identified above is not associated with the content of this activity and will not be discussed or presented on any material.

Activity Number

0864-0000-16-055-H04-T

Release Date: Jun 12, 2016
Credit Expiration Date: Jun 12, 2017