ADR Rx Reporting
Contents
1. category topics adap data report adr ADR Instruction Manual https careacttarget org library adr instruction manual Sortable Drug Spreadsheet https careacttarget org library drugs required reporting adr Multum Request Form httos careacttarget org library hab grantee request form multum medication information TRAX Download Package https careacttarget org library trax adr CAREWare Topic Page https careacttarget org category topics careware On this slide are links to important ADR tools and resources The first link is for the main ADR topic page where you will find links to all ADR related tools trainings and webcasts including the updated ADR Instruction Manual The direct link to the manual is the second link on this slide In the third slot is the sortable drug spreadsheet mention earlier Next is the link to the Multum database request form Then comes the link to the TRAX package and user You ll also find links to the archived webcast with instructions on how to use this tool to create your XML file And finally the CAREWare topic page on TARGET includes a link to HAB s CAREWare Portal where you can find user manuals and links to download the latest build Note that an easy way to find these resources quickly is to search by topic or keyword in the search box on the TARGET Center website For example you can simply type Multum in the TARGET Center search box and you ll see the li2. R there are just a few dozen d codes you ll need to report d codes for New Medicati New HIV Medication Generic Name Brand Name Drug Identification Number d code Cobicistat Tybost 07897 Elvitegravir Stribild 07899 Cobicistat and Darunavir _ Prezcobix d08305 Atazanavir and Cobicistat Evotaz 08340 New Hepatitis Medication Generic Name Br i Number d code Ledipasvir Sofosbuvir Harvoni 08296 Ombitasvir Paritaprevir d08323 Ritonavir with Dasabuvir Viekira Pak Speaking of d codes there are six new drugs and corresponding d codes are being added to the ADR web system that will open for submissions on Thursday April 10th 2014 Four new HIV medications were added brand names Tybost Stribild Prezcobix and Evotaz Two new Hepatitis medications were also added brand names Harvoni and Viekira Pak The generic name and drug identification number or d code are listed for each here New Resource for ADAPs Sortable 1 Drugs Required for Reporting in the ADAP Data Report ADR spreadsheet with aa abu ager ours Sja abwcavflaniding acon dosse o d code Bav osc vtec tao sanr o Drug type rns Tyas oon DIAN cobcetat and Darnae Pereobix 1901305 o Drug name TAR darunavir Prezista 05825 aN delvise emptor eA lav dtreane Videxyvidexec ooo isaw eters Suna sous 5 AN _evrenc emirctabinetenfc arpa soot le hee som WARY eimtegravrfeobicistat tenofov std comes SIAN ermetaune ene soa
3. Tools for Reporting Medications in the ADAP Data Report ADR ADAP Data Report ADR HIV AIDS Bureau April 22 2015 o BCA AN Messer Welcome to today s webcast Thank you so much for joining us today My name is Ellie Coombs am a member of the DART Team one of several groups engaged by HAB to provide training and technical assistance to state ADAPs during the implementation of the ADR Today s presentation addresses Tools for Reporting Medications in the ADAP Data Report or ADR Our presentation will be led today by Michael Costa also a member of the DART team We also have several members of HAB s TA contractor teams available on the line today to help answer your questions At any time during the presentation you will be able to send us questions using the Question function on your control panel on the right hand side of the screen You will also be able to ask questions directly live at the end of the presentation You can do so by clicking the raise hand button on your control panel and my colleague Debbie will conference you in or you can click the telephone button and you will see a dial in number and code We hope you consider asking questions live we really like hearing voices other than our own Now l Il turn the presentation over to Michael pics for This Webcast Tools available for ADAPs to report client medications o CAREWare o TRAX o Multum data
4. ation especially pages 21 and 22 This Manual has been updated for the 2014 ADR submission and is now available from the TARGET Center website What Medications Do Rep ARVs Hepatitis B and C medications A1 Ol medications new for 2014 The types of drugs you report in the ADR have changed for 2014 Previously you just reported ARVs and Hep B and C medications Starting in 2014 you also report the A1 Opportunistic Infection medications or A1 Ol as they are known What Client Medications Do NOT Report Medications that were purchased by the ADAP and billed to insurance Medication for which only co pays and deductibles were paid Medications other than ARVs Hepatitis B and C medications and A1 Ol medications As a reminder you would not report medications that were purchased by the ADAP and then billed to insurance those for which only co pays and deductibles were paid those would be reported under insurance or medications other than ARVs Hepatitis B Hepatitis C and A1 Ol medications So for example if your formulary covers mental health medications those are not included ADR Client Medication Table Item 25 Receipt of Medication Services o If yes for a given client then you must report four additional data elements Item 26 Medications Dispensed d xxxxx ltem 27 Medication Dispensed Date Item 28 Days Supply of Medication Item 29 Amount Pa
5. base tables Data quality issues to look for o Correct d codes o Over underuse of d codes o Dummy codes o New codes Support resources Presenter Thanks Ellie Today s webcast describes the tools available for ADAPs to report client medications These include CAREWare TRAX and custom requests for Multum database tables Not sure which situation fits you In this presentation we ll review the options to help you determine what you may need But first let s review the reporting requirements hat Medications Do Report Drug and Drug Expenditures should be reported only for clients who were dispensed ADAP funded medications that were paid for in full by ADAP Medication co pays or deductibles should be reported in the Insurance Services section ADR Instruction Manual pp 21 22 https careacttarget org library adr instruction manual The purpose of the Drugs and Drug Expenditures section is to describe the ADAP funded medications i e ARV Hepatitis B Hepatitis C and A1 Ol medications dispensed to clients during the reporting period and the total expenditures for those services This section is only for clients who were dispensed ADAP funded medications that were paid for in full by ADAP ADAP payments for medication co pays or deductibles are considered insurance assistance services and should be reported in the Insurance Services section See the ADR Instruction Manual for more inform
6. d to make sure that you have what you need already including d codes If you are missing d codes do NOT report dummy d codes in your client XML file Rather use one of the methods described in this presentation to obtain the appropriate codes to report client medications I m going to quickly review where you can find these resources 14 eporting Client Medications in CAREWare ADAP drug services module medication list o Contains virtually all approved drugs o Generic medication name o d codes o Brand name o National Drug Code NDC Make sure you are using the latest build 839 If you are using CAREWare The CAREWare ADAP drug services module is designed to allow grantees who manage these services to track in detail client level AIDS Drug Assistance information The module includes a complete medication list and all client level fields required for the ADR CAREWare uses the Multum medications database as the source of data for the medications list The medications list is extensive and contains virtually all approved drugs cross referenced by generic ingredient along with the associated d codes brand name and National Drug Code or NDC As a reminder if you will be using CAREWare to generate your 2014 ADR please be sure you have downloaded and are using Build 839 15 eporting Client Medications in CAREWare http hab hrsa gov manage yourgrant careware adapm odule20121115
7. es from the TARGET Center website You ll also need to install the TRAX application from the link provided on the TARGET center website In addition to reading the User Manual You may also find it helpful to review the March 25 2015 TRAX webcast on the TARGET Center entitled Tool for RSR and ADR XML Generation TRAX e https careacttarget or 17 eporting Client Medications Using TRAX Report a row for each unique combination of client d code and dispense date Client has three rows o Two d codes o One d code with two dispense dates a BE c D 1 Clientid Medicatio MedicationStartDat Medicatio 2 lt 21165 d00034 9 10 2014 200 3 d00034 12 10 2014 a gt 4 03858 12 10 2014 After you download the TRAX zip package from TARGET you ll want to review the files that contain sample data for every TRAX table In the medications tab you report a row for every unique combination of client d code and dispense data You will report each time the medication was dispensed to a client So you may have multiple rows corresponding to one client In this example the client has three rows One d code has one dispense date and another d code has two dispense dates How Do Report Client Medications e You re not ready to go if you don t use CAREWare or don t collect d codes e Request Multum medication information Enables you to match your medication to d codes thr
8. exicomp the proprietors of the Multum database to allow HAB to provide medication information to their funded grantees In order to be eligible to receive this information you must use it for the purposes of HAB reporting outlined in your request and you may not share it You can download the request form from the TARGET Center would like to note that 23 ADAPs have downloaded it already so you may want to check to see if someone on your team already did the request and download before requesting it again 20 Requests for Multum database tables DART forwards to HAB for review and approval ADAP submits form to DART team data ta caiglobal org Automatic Peer If approved ye HAB sends ADAPs previously encrypted link and approved password in 2 emails Grantees should submit the completed form via email to Data TA caiglobal org with the subject line Multum Database Request Requests will be processed and logged by the DART team Once we receive your request form we ll review it to ensure that it is complete and forward it to HAB If it is not complete we ll return it to you with instructions to complete the missing information If it is complete we ll let you know that we have forwarded it to HAB for review HAB will review the request to determine if it aligns with their user agreement with Lexicomp HAB will then inform DART if approved If not approved HAB will provide a reason why HAB wil
9. id for Medication There are five data elements in the ADR Client Medication Table corresponding with Items 25 29 of the ADR Client Report If the response to Item 25 Receipt of Medication Services is Yes for a given client then you must report four additional data elements You ll report on each ADAP funded medication dispensed to the client during the reporting period For Item 26 you ll report the Medication ID Use the five digit drug code or d code d xxxxx for the medication You ll also report the date each medication listed in Item 26 was dispensed Item 27 number of days supply dispensed Item 28 and the amount paid for the medication for each dispensing event Item 29 Many drugs many codes d codes assigned by Multum o Also called DNUM or DIN One code for all drugs with same generic name There many many drugs with different names and product codes that vary across state data systems In order to standardize and simplify drug reporting for the ADR HAB required ADAPs to report medications using d codes d codes are unique 5 digit codes assigned by the MULTUM Lexicon drug database You may also see d codes referenced as DNUM or drug number or DIN which stands for drug identification number The d code is the same for all drugs with the same Generic Name So instead of needing to track and report hundreds of individual drug product codes for the AD
10. l forward approved requests to their IT systems contractor Leidos who maintains the encrypted Multum database file HAB will send the approved ADAP two emails The first will include a link to the encrypted Multum database The second email will outline the terms of use of the medication information and will include the password to unlock the file Note that the Multum database is updated each time a new drug is released although there is some time lag Once you ve been approved to receive the Multum database you will automatically be notified when updates are available HAB s goal is to provide these updates quarterly 21 umma Tools available for ADAPs to report client medications o CAREWare o TRAX o Multum database tables Data quality issues to look for o Correct d codes o Over underuse of d codes o Do not use dummy codes o New codes for 2014 Support resources Let s summarize what we have covered so far today First there are several different approaches that you can use to upload your ADAP client level data depending on your circumstances Next we want you to be aware of the key areas that affect data quality Lastly we want to be sure you are aware of the support resources available to you for uploading these data and assuring completeness and quality Lets review where you can find some of those resources 22 ARGET Center Web Resources ADR Topic Page https careacttarget org
11. like hearing voices other than our own We do want to get all of your questions answered and we do not usually run over an hour If you have submitted your question in the chat box and we cannot respond to your question today we will contact you to follow up We often need to explore your question in order to give you the most appropriate answer Moderator reads questions from the log while Organizers assign these to appropriate panelists and presenters 25 More Questions No Wrong Doo DART Team Who to Contact for TA https careacttarget or Data TA caiplobalorg library adr ta brochure Data Support 1 888 640 9356 RyanWhiteDataSupport wrma com HRSA Contact Center 1 877 464 4772 or http www hrsa gov abou t contact ehbhelp aspx As always feel free to contact any of the TA contractors for all of your questions about data and reporting You can also contact your Project Officer to help you make TA requests or answer programmatic questions If you re not sure who to call don t sweat it call any of us As you exit this webcast today we d like your feedback on this webcast presentation On your screen you will see three evaluation questions appear Please take a moment to respond to each We appreciate your feedback very much and use this information to plan future webcasts Thank you for joining us 26
12. nk for the Multum request form on the search results page 23 Upcoming Webinars E May 06 RSR Town Hall May 20 Data Completeness ADR Jun 03 Reviewing Your Data at Upload Tools within the ADR Web System Jul 08 ADR Town Hall There are another four webcasts that you can attend three of which focus on the ADR We hope you will join us for those as well As always you can find the right on TARGET and register to attend At this point l Il turn things back over to Ellie 24 estions amp Answers e Please submit questions woessowconroi 5 ase P in the chat box at any tween udio Moda U5 Telephone Audio Mode Uss Mic amp Speakers A Faise hand a woreo time OR Ere Viton tis TEAC wa e Raise your hand to ask your question live and we ll connect you TAU webinar nyu stouis taxe a ard aaah rra GoToWebinar Moderator Thank you We will now take questions As a reminder you can send us questions using the Question function on your control panel on the right hand side of the screen You can also ask questions directly live You can do this by clicking the raise hand button on your control panel If you are using a headset with a microphone my colleague Titi will conference you in or you can click the telephone button and you will see a dial in number and code We hope you consider asking questions live we really
13. o CAREWare Some of you directly input drug data into CAREWare Some ADAPs are actually relying on their PBMs which process medication claims to create the ADR And finally a large group of states have homegrown databases to manage drug claims and expenditures 13 How Do Report Client Medications You re ready to go if you o Use CAREWare Build 839 Functionality built in o Already have d codes for medications Can use TRAX or your home grown application Reminder If you use TRAX you have to be able to map your medications Do not report dummy d codes for the ADR Now l Il review what tools are available for you to use If you use CAREWare you re ready to go because the information that you need is built into CAREWare Make sure you have installed the latest version of the software which is Build 839 You ll need to set up your ADAP formulary in the data system and enter the medication that was dispensed to the client dispensed date number of days supply dispensed and cost Then you re all set Just make sure that you receive this information from your pharmacy PBM or other provider Now if you don t use CAREWare but you already get all of the information you need to report client medications you can use TRAX TRAX let s you pull the information that you have into an application that puts it in the right format However it doesn t add any missing information so you nee
14. ou are missing d codes for more than 20 of your clients 11 Change in Schema Requiremen If ad code is reported for a client the ADAP should report medication o Dispense date o Days supply o Amount paid Previously missing sub elements resulted in schema error file could not be uploaded Starting in 2014 file can be uploaded but data will be considered missing want to note here a change in reporting requirements that could affect your data completeness Previously you had to include in your file the medication dispense date days supply and amount paid per d code If these data were missing your file would be rejected This could lead to dummy data which HAB does not want Starting in 2014 a file can be uploaded with these variables missing and you will see the impact in your completeness rates 12 CAREWare o State imports data from PBM on a regular basis o Pharmacy or state staff input drug data directly into CAREWare PBM itself is responsible for creating the ADR client level data file State collects and reports drug data through an internal data management system Through the calls we ve been doing with ADAPs we ve been learning a lot about how you collect and report medications And of course processes are quite varied Many of you about half are using CAREWare Most CAREWare users receive files from their PBMs on a regular basis and import these data int
15. ough lookup tables So now we re going to discuss what to do if you aren t going to use CAREWare and don t already have the d codes that you need to report For example perhaps you collect NDCs or brand names and need to add d codes to your database How can you do that Not to worry HAB has contracted with Lexicomp to provide you with access to the Multum database Multum information is provided in lookup tables So it is a good option if you use Access or Sequel and are used to using lookup tables or have a programmer who knows how to work with lookup tables One important thing to note if you previously used HAB s crosswalk to map between the NDCs and d codes HAB is no longer using the crosswalk HAB s arrangement with Multum to get the databases replaces the use of that crosswalk 19 Requests for Multum database tables To be eligible to receive HAB Grantee Request Form Multum this information you Medication Information must use it for HAB ork 2033 reporting as outlined in Sara SENS your request and you may not share it Download the request form from the TARGET Center https careacttarget or library hab grantee request form multum medication information If Multum fits your needs you will need to complete a form to request medication information from the Multum Drug Database This database will enable you to collect manage and submit required data to HAB HAB contracts with L
16. pdf ow ove ibe CARE 105 O03 ettanes Program ADAP Mee ants ne SDP Data Repon AOR Activating the ADAP Formulary Medications List p 4 e https careacttarget org lib rary using careware adap data report In order to enter ADAP drug services for your clients in CAREWare you ll need to setup your active formulary This includes finding the medications adding them to your active list and supplying any available default information such as drug dispensing fee unit cost of the medication and days typically prescribed These settings can always be edited and even changed at the point of client level data entry For step by step instructions on setting up your drug formulary in CAREWare please refer to the manual on How to use the CAREWare ADAP Module to complete the ADR This manual is available on the TARGET Center website through the URL listed on this slide as well as the CAREWare Portal on the HAB website You might also find it helpful to review the November 2012 webcast archive on Using CAREWare for the ADAP data report which is available from the TARGET Center 16 porting Client Medications Using TRAX OTARGET Center Download the TRAX package and install the TRAX software library trax adr Now if you plan to use TRAX to create your XML file You ll first need to download the TRAX package including the User Manual and sample ADR Client Tabl
17. ssa 20 ARV emtricitabine rilpivirine tenof Complera 407796 https careacttarget org library drugs required reporting adr To help you identify the d codes you should be reporting we created a new resource on TARGET that lists the d code drug type and drug name Some ADAPs May Be Under or Over Reporting d codes Number of Unique Number of ADAPs d codes Reported Too many Now I want to talk about some trends in data quality that we have seen from the different approaches to reporting data One issue we have seen with the non CAREWare users is the over or under reporting of d codes This table shows the number of ADAPs that fell into each level of number of unique d codes reported in 2013 Most of you 35 reported between 20 and 35 d codes 4 of you reported fewer than 20 and 15 of you reported more than 35 We point this out not to prescribe a range rather we just note it to help you think about whether you believe there could be quality issue regarding your data That is does it seem like the right number of codes for your ADAP As a reminder now that A1 Ols are required there are 84 d codes that could be reported in 2014 10 d code Completeness Clients with No d codes 37 5 2 10 In terms of data completeness the vast majority of ADAPs 37 are reporting d codes for all of their required clients However more work still needs to be done as 10 of y
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