Short Cycle Dispensing

The Centers for Medicare and Medicaid Services (CMS) are enforcing new mandates effective January 1, 2013 in order to save Medicare money by cutting down on the amount of wasted medications. This measure is a part of the Patient Protection and Affordable Care Act that requires pharmacies that dispense brand-name tablets and capsules to Medicare Part D members in CMS-defined Long Term Care (LTC) facilities do so in 14-day-or-less increments. Short-Cycle Dispensing is used for solid, oral brand name medications (including controlled substance medications) that are not considered antibiotics or medications that are dispensed from their original packaging.

CMS-defined Long Term Care (LTC) facility:

Any Medicare Part D long term care facility that is not considered assisted living, mental health or Indian tribal.

Reminder: Set the Short Cycle Days Supply Min/Max (based on Drug Unit) on each Part D Price Plan.

If a prescription is identified as Short Cycle, and the Min/Max quantities are not met, error messages display when the following conditions are met:

If the minimum short cycle dispensing quantity is not met, "Minimum Days Supply Not Met" displays.
If the maximum short cycle dispensing quantity is greater than the quantity set, "Maximum Days Supply Exceeded" displays. The Drug Record has SCD Part D Drug set to Y.
The Facility Record CMS Defined Part D is set to Y.
The Patient Residence - 03 on the Prescription Record.

Set SCD Part D and Freeze SCD

Identify Short Cycle drugs by selecting the SCD Part D field on the Clinical screen of the Drug Record.

The SCD Part D field may only be edited by the user and is updated by the following programs:

Update drug data from CD
Update drug data from QS/1 Internet Updates
Batch drug updates from CD
Price Updates from diskette

During one of these updates, this field is set to Y when all the conditions listed below are met and the Specific Therapeutic Class field does not contain a W1. The W1 Therapeutic Classes are antibiotics and excluded from SCD. The conditions are:

The FDA Drug Application Type drug field is set to 1 - New Drug Application.
The Generic Indicator field is blank or * (single source or multi source).
The Drug Unit is: CAP, TAB, CP, TB, CPM, TBD, CMB, TBM or CSM.

Drug Units for Short Cycle drugs:

Set the Freeze SCD field on the Drug Record to prevent system updates from overriding these settings.

Short Cycle Prescriptions and Transactions

Prescriptions created using SCD Part D flagged drugs and meeting the other requirements for Short Cycle Dispensing prompt the system to be flagged Short Cycle, in the upper right corner of the Prescription and Transaction screens. The Short Cycle box is also selected in the Other Information section of the Prescription screen.

Note: The Generic field must be blank.

Short Cycle Fill List Processing

The Short Cycle Fill List is processed using the same procedures as a Routine Fill List. However, an option has been added to the menu to create a Short Cycle Fill List.

Create a Short Cycle Fill List

The Short Cycle Fill List is created under the Facility Management menu. To access, click Facility Management, Create Fill List, Short Cycle. Proceed with the normal procedures to create a Fill List.

Create a Supplemental Short Cycle Fill List

The Supplemental Short Cycle Fill List is created in Facility Management. To access, click Facility Management, Fill List Utilities, Supplemental Fill List, Short Cycle. Proceed with the normal procedures to create a Supplemental Fill List.

Creating Transactions for the Short Cycle Fill List

Transactions are created from the Facility Management menu. To access, click Facility Management, Create Transactions from Fill List, and select Short Cycle. Then, follow the normal procedures to create transactions from the Fill List.