Pharmacy Support

Aligning a patient’s routine medications to be filled at the same time each month. The pharmacists will provide clinical medication management and monitoring for progression toward desired therapeutic goals during the patient appointment at time of medication pick-up or delivery. 

Screening patients for ACIP recommended immunizations, educate patients about needed immunizations and administer immunizations when appropriate. 

Comparing a patient’s medication orders to all of the medications that the patient has been taking (active, chronic, as needed and OTC including herbal) to avoid medication errors. This service is especially important during transitions of care when patients are most vulnerable to medication errors or mishaps. 
 

Providing each patient a comprehensive list of current patient medications manually or from dispensing software. 

Providing each patient receiving a dispensed medication from the participating pharmacy ready access to unscheduled face-to-face meeting(s) with a pharmacist employed by the participating CPESN pharmacy during operational hours. For pharmacies not staffing a pharmacist during operational hours, a non-pharmacist involved in the patient’s care must be available for the unscheduled face-to-face visit as well as a pharmacist via appropriate telecommunication methods upon request by the patient or the pharmacy staff-person who provides service in support of that pharmacy.

Pharmacy must have workforce member(s) that is locally available, employed by the pharmacy and is capable to deploy in the community to provide billable enhanced services (i.e. community vaccination clinic, health screenings, point-of-care testing)

• Use of mailing for delivery shall be limited to maximum of 10% of prescriptions filled via UPS, USPS, FedEx or similar. This does not include contracted courier services whereby workforce may be trained to execute trainings and other patient-related services.
• Pharmacy services no more than 10% of non-facility patients outside of 50-mile radius of registered pharmacy location. A waiver may be applicable in circumstances where a pharmacy is serving a population in rural areas.
• Pharmacy must be willing and capable to meet all CPESN Technology, Compliance, Quality Assurance Data Collection and Transmission Standards.
• Pharmacy must select a primary local network when joining CPESN

• Pharmacy must have a LTC NPI [CMS Requirement]
• Pharmacy must provide delivery of medications to patients [CMS Requirement]
• Pharmacy must offer adherence packaging services [CMS Requirement]
• Pharmacy must provide Transitions of Care Management: Support the needs of patients transitioning between levels of care by providing medication reconciliation and communicating with the patient and other health care team members [CMS Requirement]
• Pharmacy staff is available 24 hours a day, 7 days a week (as defined in CMS guidelines) [CMS Requirement] 
• Pharmacy must provide or assist in providing patient with sterile compounding medications [CMS Requirement]
• Pharmacy must have capacity to provide IV medications to LTC resident as ordered by a qualified medical professional. [CMS Requirement]

By joining a CPESN Network, pharmacies will gain access to value-based payer programs and opportunities as well as learn best practices from a nationwide network of like-minded pharmacies focused on value-based care.

Click here and complete the online form.

CPESN Networks and its member pharmacies have proven to reduce the overall healthcare costs for our payer partners. We work together with payers to develop contracts that recognize the value of local pharmacy services, including medication syncrhonization, immunizations, and chronic disease management. 

Pharmacies should contact CPESN USA immediately to resolve payment issues by emailing [email protected]. Failure to pay may result in suspension or removal from the network. 

Some local networks may charge additional fees for membership, services, or technology solutions. Pharmacies should check with their local CPESN network for details. 

Participating pharmacy locations may initiate disenrollment from CPESN USA by completing a secure electronic form click here. Or the pharmacy may send notice to [email protected]. Refer to the Notices section of the CPESN USA Clinically Integrated Network Agreement for written notices. 

Yes, a pharmacy may participate in multiple CPESN networks if they meet the service and financial requirements of each network. 

Participating pharmacies may need to submit claims data, service documentation (in many cases via the Pharmacist e-Care Plan), and patient outcome reports as required by contracted payers and CPESN quality initiatives. 

CPESN USA aims to expand payer and provider relationships, integrate pharmacy services into value-based care models, and position community pharmacies as essential healthcare providers beyond traditional dispensing.