Highmark has seen an increase in prescriptions being rejected at the point of sale due to providers having incorrect/outdated prescribing authority on file in the National Plan and Provider Enumeration System (NPPES) for the prescriptions they write. This is especially true of controlled prescription drugs due to tighter regulations on prescribing authority for these drugs.
Please take a moment to review your NPPES data, make any necessary updates, and certify its accuracy to ensure your patients don’t experience unnecessary delays and rejections on otherwise valid prescriptions.
To review your data in NPPES:
To update and certify your data in NPPES:
Review the NPPES FAQ for additional information, including information on recovering/resetting your user ID and/or password, and changing your taxonomy code. Also, visit https://nppes.cms.hhs.gov/ .
The Centers for Medicare and Medicaid Services (CMS), as well as various states, require that providers have the appropriate prescribing authority for any prescriptions they write. Prescribing authority is based on providers’ data in the NPPES.