Issued: Nov. 5, 2021
County Realignment: NC-TOPPS Member Transfers
Partners is currently identifying and transitioning members affected by county realignment who have active episodes of care in the North Carolina Treatment Outcomes and Performance Program System, also known as NC-TOPPS.
Once members are identified, each member will be assigned an Alpha ID number. The Alpha ID serves as a unique Partners’ identifier and will also serve as the new consumer record number for the member currently active in NC-TOPPS.
A list of all active consumers in NC-TOPPS, along with their new consumer record numbers, will be created and provided to the NC-TOPPS help desk. NC-TOPPS will update the location of each member on the list to Partners and add the new consumer record number. Partners anticipates that this process will be complete by early December.
If you have questions regarding NC-TOPPS, please contact Partners Quality Management at firstname.lastname@example.org.
County Realignment Reminders
Providers are reminded to frequently check the following webpages for the most up-to-date information about county realignment:
- Provider FAQs: https://www.partnersbhm.org/county-realignment/providerfaq/
- Cardinal/Partners Service Code Crosswalk: https://providers.partnersbhm.org/cardinal-partners-service-code-crosswalk/
- Utilization Management Information for providers serving members affected by County Realignment: https://providers.partnersbhm.org/um-and-county-realignment/
Providers and Pharmacists: New Clozapine REMS System Coming November 15, 2021
To help manage the risk of neutropenia, the Food and Drug Administration (FDA) has mandated a Risk Evaluation and Mitigation Strategy (REMS) for clozapine. On July 29, 2021, the FDA approved a modification to the Clozapine REMS, in conjunction with the Clozapine Product Manufacturers Group (CPMG). The modification to Clozapine REMS will go into effect on November 15, 2021. Important changes include:
- All prescribers and pharmacies must be re-certified by November 15, 2021, or they will no longer be able to prescribe/dispense clozapine.
- Prescribers must re-enroll their patients who will continue clozapine by November 15, 2021. Patients who are not re-enrolled by that day will no longer be able to receive clozapine.
- Pharmacies will no longer be able to use the telecommunication verification (also known as the switch system) to verify safe use conditions. The authorization to dispense RDA will be obtained either through the contact center or online via the REMS website.
- A new Patient Status Form (PSF) will document absolute neutrophil count (ANC) monitoring for all outpatients. This form must be submitted monthly. Patient ANC monitoring must continue per the Prescribing Information; however, this is provider driven in the new system. After enrolling the patient, the REMS system requires a detailed Patient Status Form (PSF) monthly. Currently there is no electronic PSF.
- Provider or pharmacy failure to re-enroll or re-certify may lead to clozapine interruption, which could result in significant consequences and negative outcomes for individuals stabilized on clozapine.
- Designee assignment: Providers must initiate the designee process. Further, pharmacists in the past have been in a position to be named provider designee for more than one provider. This will not be the case in the new REMS system. Also, nurses may not be designees for more than one provider. There must be a 1:1 relationship between the provider and the designees in the new REMS.
- The ANC monitoring frequency will not automatically change on its own. The prescriber will have to keep note of when they switch to every-two week or monthly monitoring because the program will no longer notify you like before.
- Inpatient vs. Outpatient Management: If a community hospital admits a patient on clozapine and the pharmacist obtains a Required Dispense Authorization (RDA), and then the patient is discharged three days later, the inpatient pharmacist must reverse the RDA so the outpatient pharmacy can fill the prescription. An RDA for an inpatient is only required initially. As long as the patient is hospitalized, no follow-up RDA is necessary. The RDA requirements for new starts in the hospital follows the ANC lab draw frequency, so ANC weekly then obtain weekly RDA, if monthly, then monthly RDA etc.
- Please note the change in REMS vendor:
- New REMS vendor: Syneos Health®
- New phone number: 888-586-0758
- New fax number: 800-878-5927
- Transition website: https://www.newclozapinerems.com/home
Providers are reminded that they are required to submit the death certificate/medical examiner’s report within 90 days of a member’s reported death. Beginning July 1, 2021, Partners Quality Management Monitoring Unit will begin issuing a plan of correction (POC) to providers for their failure to submit the death certificate/medical examiner report within the required 90-day time frame. Providers may submit any death certificate/medical examiner report for a deceased member to Deborah Jackson at email@example.com.
If a provider is unable to obtain the death certificate/medical examiner’s report within 90 days of a member’s reported death, providers are asked to notify Deborah Jackson at firstname.lastname@example.org with their documented efforts to obtain the required documentation and a POC will not be requested.
Upcoming Trainings and Meetings
Partners Provider Council
Nov. 19, 2021, 9:30-11:30 a.m. (Register)
The Partners’ Provider Council is for professional representatives and advocates for all service providers in the Partners’ catchment area. The Council facilitates an open exchange of ideas and brings forward concerns and solutions while promoting collaboration and mutual accountability among providers.
I/DD and Innovations Provider Breakout Session
Nov 19, 2021 -2 p.m. (Register)
The I/DD and Innovations Provider Breakout Session is an opportunity for providers to share and discuss issues or concerns with Partners I/DD Care Management and Utilization Management departments.
Long-Term Community Supports Service Definition Training for Providers
Nov. 22, 2021 10-11 a.m. (Register)
Join us for Long-Term Community Support (LTCS) training. Providers will learn more about this Partners’ In Lieu of Service definition and steps required to successfully transition members served from State-funded services to LTCS.