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Quality Assurance and Medicare

There are many quality assurance practices that occur in the pharmacy that makes it as safe as possible. QA occurs when the team works together to assure that each step in the filling procedure is done accurately, consistently and with good pharmacy practices employed throughout the process. Some pharmacies use CQI or Continuous Quality Improvement to evaluate the safest procedures used to fill prescriptions, recognize areas for potential misfills and when needed, support those that have committed an error with improvement strategies to prevent the error from happening again. Most pharmacies have a system that routinely checks and monitors the complete filling process. Are the techs pulling the right meds with the correct NDC, are they being distracted in the course of counting and applying the labels, are meds being put back in the correct bottle from the counting tray, are the directions being typed into the computer consistent with the dosing and med. There are so many areas where QA can be breached that we all need to make sure that accuracy is the most important part of what we are doing.  Along with QA practices, technicians have an ethical responsibility to abide by guidelines set up by certain organizations. We have all heard of waste, fraud and abuse in relation to rules set down by the Centers for Medicare and Medicaid services. Fraud is where pharmacy staff personnel might bill for brand name drugs instead of the generics that were given, basically, willingly obtaining money under false pretenses from healthcare benefit programs or insurance, Waste is caused by overuse of materials or services causing unnecessary costs to these programs. Abuse occurs when payment happens due to deliberately distorted facts. As long as the technician has strong moral standards, they should be ethically compliant.

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