CMS Ensured Nearly All Part D Drug Records Contained Valid Prescriber Identifiers in 2016

Prescriber identifiers are a valuable program integrity safeguard. They enable CMS and Part D plan sponsors to determine if legitimate practitioners have prescribed drugs for enrollees. Plan sponsors are required to include prescriber identifiers on the Part D prescription drug event (PDE) records they submit to CMS. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires that, beginning in 2016, pharmacy claims for covered Part D drugs must contain valid prescriber National Provider Identifiers (NPIs). Additionally, the law requires the Secretary of the Department of Health and Human Services to establish procedures for determining the validity of these prescriber NPIs. The law also requires OIG to submit to Congress a report on the effectiveness of these procedures no later than January 1, 2018. This evaluation report fulfills OIG's MACRA mandate.