The following documents were compiled and/or created by MPA as a resource to members for pharmacy issues, including those related to third party reimbursement.

Provider Exclusion Lists
Pharmacists are reminded that they should utilize Web sites provided by the Department of Health and Human Services and General Services Administration to determine if an employee or contracted individual/entity is excluded from participating in any federally funded program, including Medicare, Medicaid and other programs that provide health benefits (other than the Federal Employees Health Benefits Plan). 

Instructions for Submitting a Mail-Order Allegation
This document outlines how to submit a complaint to the Department of Community Health regarding mail-order pharmacy.

Treatment Data Form
This form must be filed with the Department of Community Health, Bureau of Health Professions, along with the Mail-order Pharmacy Allegation Form and Authorization for Release of Privileged/Client Information Form. A sample form is also available for further assistance.

Authorization for Release of Privileged/Client Information Form
This form must be filed with the Department of Community Health, Bureau of Health Professions, along with the Mail-order Pharmacy Allegation Form and Treatment Data Form. A sample form is also available for further assistance.

Mail-Order Pharmacy Allegation Form
This form can be used either by the pharmacist or by a patient to report issues related to mail order pharmacy. Forms should be copied to MPA for the purpose of recording evidence of problems with mail order pharmacy.

Discrepancy Reporting Form
This form was developed as a tool for pharmacies to report third party payment discrepancies. MPA requests that the form be submitted to MPA, as well as the third party payor, so these discrepancies may be recorded.

Price Discrepancy Complaint Form
This form was developed for the purpose of filing a complaint about incorrect information on the Department of Community Health Drug Pricing Web site.

Other Resources

• MPA's Online Pharmacy Forum
• Medicare Resources
• Michigan Automated Prescription System (MAPS) Online
  • MAPS Online User Guide and Instructions
  • Request for MAPS Report - Pharmacist or Practitioner
• Medicaid Fraud Reporting
• Michigan Medicaid MAC Manager
  The Medicaid MAC Manager contains contact information for Michigan Medicaid pharmacy providers who have inquiries about Medicaid MAC price irregularities
• Michigan Board of Pharmacy
• Pharmacy Quality Commitment
  PQC is a continuous quality improvement (CQI) program that supports you in responding to issues with provider network contracts, Medicare Part D requirements under federal law and mandates for CQI programs under state law.