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Electronic Prior Authorization: Minnesota Adoption & Impact on Workflow

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Physicians, pharmacists and their staff waste a tremendous amount of time responding to prior authorization (PA) requirements for medications. Despite their effort, patients abandon prescribed medications at high rates due to process inefficiencies and communication challenges — and the problem is only growing. Health plans will increase prior authorization requirements by over 20 percent this year. Many are not aware of the full impact of the phone and fax-based prior authorization process, or that a standards-based technology solution exists.

Join us for the MPhA Virtual Coffee Break on January 20, 2016 from 11:30 am to 12:30 pm. This webinar is an opportunity to learn about prior authorization requirements, the current state of electronic prior authorization (ePA) adoption across the industry, and the challenges to broader and faster adoption. Minnesota’s ePA requirement went into effect January 1, 2016.

Kim Boyd from CoverMyMeds will share insights around the process of transitioning to electronic prior authorization and answer questions regarding the effects on workflows, as well as overview legislative trends mandating the electronic transmission of prior authorization.

Learning Objectives:

  • Explain the prior authorization problem including related factors and challenges
  • Describe a prior authorization solution and the role the pharmacist plays
  • Understand the prior authorization channels & related barriers to adoption and pharmacy engagement
  • Explain what electronic prior authorization is, the associated methodologies and the electronic standard
  • Understand and describe the impact of the Minnesota Prior Authorization Mandate and their role

Presenter: Kim Diehl-Boyd, Director of Industry Relations and Government Affairs, CoverMyMeds

Kim Diehl-Boyd is the Director of Industry Relations and Government Affairs for CoverMyMeds. Kim has worked in the Pharmacy and Ancillary Services arena for over 15 years. Prior to her work with CoverMyMeds, Kim was employed by the National Council for Prescription Drug Programs (NCPDP) cultivating new markets and proactively engaging with government entities, industry regulators and key legislative team members to identify regulatory and legislative initiatives impacting NCPDP members. Kim has been a member of NCPDP for 15 years and has held leadership roles on various committees and as a Workgroup Co-Chair.

Previous to NCPDP Kim worked within the pharmacy workers’ compensation arena with Helios (formerly StoneRiver Pharmacy Solutions and One Call Care Management (formerly MSC) in various capacities including pioneering the government affairs and compliance division, conducting lobbying efforts and testifying before state legislative committees including the State of Minnesota. Her efforts have contributed to the passage of positively impacting legislation and regulation to include, prior authorization, formulary and benefit management, electronic billing and reimbursement using the nationally adopted NCPDP standards.

Registration Fees:

The Webinar is complimentary to MPhA members (including students and residents) thanks to an educational grant from CoverMyMeds.

The cost is $25 for nonmembers.

Continuing Education:

This presentation is being submitted to the Minnesota Board of Pharmacy for Continuing Education credit approval (one hour).

To receive Board of Pharmacy credits for this program the following must be completed:

  • Full participation/completion of webinar either during the live program or the archived presentation

  • Completion of survey post webinar acknowledging participation

Board of Pharmacy credit processing takes place on the 15th of each month.

The Minnesota Pharmacists Association is accredited by the Minnesota Board of Pharmacy as a provider of continuing pharmacy education.

Questions? Please contact karip@ewald.com with questions about credits.

Please contact jessicag@ewald.com with any technical questions or issues.

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