Modern Pharmacy Blog

Mastering short-cycle dispensing rules is crucial but often challenging. They can be confusing and prone to pitfalls like improper coding that leads to under-reimbursements. To understand why these rules exist and how they impact long-term care (LTC) pharmacies, let's explore their origins.

On December 8, 2003, President George W. Bush signed the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 into law. It quickly got shortened to the Medicare Modernization Act (MMA) and Medicare, at long last, had a prescription drug benefit.The bill passed along partisan lines, with Republicans prevailing in the House by a vote of 220-215, and in the Senate by a tally of 54-44. Democrats worried about the $394 billion price tag, and the potential implications of the increased role of private insurers in Medicare.

We’ve all seen the news stories about drug compounders filling the gap caused by a shortage of the GLP-1 drugs tirzepatide, Lilly’s Zepbound, and semaglutide, Novo Nordisk’s Wegovy, approved for the treatment of obesity. So, what rules govern how a compounding pharmacy is authorized to legally create a version of a patented drug when the drug is declared to be in short supply?