Arrangements for contractors concerning prescription pricing errors (Drug Tariff Part XIVB)

This information applies to pharmacy contractors in England only.

From 1 April 2012

From April 2012, a contractor who thinks there is an issue with their monthly payment can ask the NHSBSA, in writing, to recheck a month or specific months' prescriptions.

All contractors who provide NHS pharmaceutical services can request a month or specific months' prescriptions to be rechecked. Contractors who have purchased a business since 1 April 2012 can only request a recheck for the months where they owned the business, unless they have purchased the business with liabilities and the account code has remained unchanged. Those contractors who ceased trading after 1 April 2012 and not sold the business with liabilities can request a recheck for any month where they owned the business, subject to the normal limitation periods.

To request a recheck from NHSBSA:

  • A contractor must submit their request using the appropriate form available to download here in PDF format (to download in MS Word format click here). NHSBSA has redesigned the proforma pharmacy contractors must use to request a re-check of a specific month’s account(s) in order to allow contractors to indicate the nature of the enquiry which has affected payment.  Any information that may assist the NHSBSA in checking the account(s) should be entered in the additional information box provided.
  • All requests must be submitted no later than 18 months from the end of the month of dispensing e.g. for prescriptions dispensed in April 2012 a contractor must submit their request for a check by 31 October 2013.
  • A separate form needs to be completed for each month they wish to have checked. Contractors with more than one pharmacy need to complete separate request forms for each pharmacy and month they wish to have checked.

To ensure that adjustments fairly reflect both underpayments and overpayments, the NHSBSA will select an equivalent number of additional months to check where appropriate. Using the results:

  • Where a net underpayment is revealed, the contractor will be paid the value of the underpayment.
  • Where a net overpayment is revealed, the NHSBSA will recover the value of the overpayment.

Once the 18 month deadline for requesting a check has elapsed (e.g. 31 October 2013 for prescriptions dispensed in April 2012) no further requests can be made for that particular month.

For the period 1 April 2011 to 31 March 2012

The final report to the Department of Health on the prescription re-pricing exercise for this period can be found here.

For the period 1 April 2009 to 31 March 2011

The final report to the Department of Health on the prescription re-pricing exercise for this period can be found here.