Home Medicines Use Reviews - Claims for Payment
The Department of Health has issued guidance to Primary Care Trusts on monitoring the numbers of Medicines Use Reviews that have been carried out and how to deal with claims which exceed the annual threshold.
Claims made by pharmacy contractors for Medicines Use Reviews are paid on trust. However, the NHS Counter Fraud and Security Management Service have confirmed that as with other systems where remuneration is paid based on a self declaration, the Service has monitoring arrangements in place to detect fraudulent activity. To avoid any suggestion of a fraudulent claim, or simply poor practice in making claims for payment, we would recommend carrying out the following checks:
1. Before submitting any claim for payment of MURs (using Form FP34C), contractors should ensure that copies of the certificates of accreditation for every pharmacist who may undertake MURs at the pharmacy have been sent to the PCT (the PCT may monitor this during the monitoring visits);
2. Each month, carefully check the pharmacy records of MURs undertaken that month, to ensure that the pharmacist who undertook the MUR consultation is accredited (and the certificate sent to the PCT as above);
3. Each month count carefully the number of MUR reports for consultations carried out that month, to ensure that an accurate claim is made. These reports should be filed safely as they are the main evidence that an MUR has been carried out. Contractors may be required to produce them in the event of a Counter Fraud investigation;
4. Maintain a cumulative log of numbers claimed, so that the limit is not exceeded (currently 250 reviews per year);
5. If any MUR consultations are to be conducted away from the pharmacy premises, contractors should check that they have written confirmation of the consent of the PCT, which should be carefully filed in the pharmacy.
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