NHS England to start spot-checking NMS payment claims this month
NHS England will begin spot-checking selected English contractors' new medicine service (NMS) payment claims in the next stage of its national pilot.
From mid-January, the NHS Business Services Authority (NHS BSA) will start to “request evidence” from contractors to support their NMS payments claims over a three-month period, according to the Pharmaceutical Services Negotiating Committee (PSNC).
Same process as MUR payment checks
Alastair Buxton, PSNC director of NHS services, said the post-payment verification for NMS would “follow the same process” as that used to verify contractors’ medicines use review payments, which began in October 2017.
“The NHS BSA will request evidence from a sample of contractors, including those identified as being outliers due to having made very high claims for the service in the month in question compared to the average for all contractors, and a random selection of other pharmacies,” Mr Buxton said.
To prepare, all contractors should review how they currently file signed patient consent forms, said Mr Buxton, who also stressed that only contractors contacted by the NHS BSA will need to submit their NMS forms.
“It is expected that post-payment verification of claims for the flu vaccination service will be the next advanced service to adopt this process, but there is no date for the implementation of this as yet,” he added.
“Standardising the approach”
NHS England asked NHS BSA to pilot a national process for parts of the post-payment verification and performance management of advanced services, in order to take a “standardised and centralised approach”, PSNC said.
The standardised approach aims to “identify any issues related to the claiming of payment for advanced services” and to "facilitate resolution of those issues with the individual contractor," the negotiator added.
How do you think the NMS service could be improved?