End of an Era: Lessons Learned from 2018 CMS Audits, and Prep for the Future - Nexus 2018

ACPE UAN #:  0233-0000-18-061-H04-P

Release DateOctober 24, 2018

Expiration Date:  October 24, 2021

Activity Type:    Knowledge-based

Contact Hours:  1.5

Activity Fee:  Member:  Free        Non-Member: $30

Target Audience: Pharmacists who practice in managed care settings.

Activity Description

Ready for that upcoming 2019 audit? Do you know how to prepare?   If your answer is no, join this session to hear how health plans prepare for their audits and address corrective actions, as lessons learned from the 2018 audit season are discussed. This information will help health plans and pharmacy benefit managers (PBMs) mitigate risk, update their monitoring and auditing programs, and prepare for the next generation of audits that will kick-off 2019. 

This session will also discuss how the 2019 draft/final audit protocols will impact ongoing audits, including the Formulary Administration Audit (FAA) and Timeliness Monitoring Project (TMP).

Learning Objectives:  

At the completion of this activity, participants should be able to:

  1. Identify the Centers for Medicare & Medicaid Services (CMS) Formulary Administration (FA) audit top trends from the 2018 audit season.
  2. List the CMS identified best practices from health plans for the 2018 audit season.
  3. Recognize common risks that need corrective action before the 2019 audit season.

Schedule of Educational Activity

This activity consists of an audio recording, pre-test assessment questions (not required to pass or continue), post-test questions (required to pass with a score of 70% or higher) and a specific activity evaluation. 


The Academy of Managed Care Pharmacy (AMCP) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

As an accredited provider, AMCP strictly adheres to the ACPE Standards for Commercial Support and other relevant guidelines and standards to ensure the independence of continuing pharmacy education (CPE) activities.  It is AMCP’s intent that all CPE activities be independent, objective, balanced, evidence-based and free of any commercial bias.

CPE Requirements:   

Participants should claim continuing pharmacy education (CPE) credit for this home study activity only if they have not claimed credit for the live activity presented at AMCP Nexus 2018. CPE credit will be processed through the AMCP Learn portal and reported directly to CPE Monitor.  Please allow 72 hours for processing and posting in your NABP account.

To receive credit for an online activity you must:

  • Review the full content of the activity.
  • Successfully complete the post-test (required to pass with a score of 70% or higher, it may be taken a maximum of three times).
  • Complete a specific activity evaluation.


Michael Dillon, MS, RPh | Medical Science Liaison | Aries Pharmaceuticals | Mechanicville, New York.

System Technical Requirements/Viewing Requirements: System Requirements Courses and learning activities are delivered via your Web browser and Acrobat PDF. For all activities, you should have a basic comfort level using a computer and navigating websites.  View the minimum technical and system requirements for continuing education online learning activities.

Credit Information

Activity Number Credit Amount Accreditation Period
ACPE UAN #0233-0000-18-061-H04-P 1.5 Contact Hours October 24, 2018 - October 24, 2021