Reminder: Check and challenge your disallowed items using MYS

A disallowed item is one that has NOT been passed for payment by the NHS Business Services Authority (NHSBSA). Community Pharmacy England is encouraging pharmacy owners to check their disallowed items history on the Manage Your Service (MYS) portal to identify any unpaid items and check the reasons why these were disallowed by the NHSBSA. If an item is believed to have been incorrectly disallowed, pharmacy owners should submit a challenge to the NHSBSA, who will investigate the issue and rectify any missing payments if a pricing error is identified. 

Previously, Community Pharmacy England reported that certain prescriptions for Hypromellose 0.3% eye drops (10ml) were incorrectly disallowed by the NHSBSA. This occurred because NHSBSA was only reimbursing generically written prescription for Hypromellose 0.3% eye drops (10ml) based on brands listed in the ‘Eye Drops – Hypromellose’ section in Part IXA of the Drug Tariff. 

However, many pharmacies were supplying a licensed drug manufactured by Alissa Healthcare Research Ltd which NHSBSA was unaware of as the product was not listed in the NHS dictionary of medicines and devices (dm+d). Where the Alissa Healthcare product was supplied against a prescription for Hypromellose 0.3% eye drops (10ml), it should have been reimbursed as a non-Part VIII product by the NHSBSA based on the endorsed price (or referred back to the pharmacy in the absence of an endorsement).

Following representations made by Community Pharmacy England, NHSBSA added the Alissa Healthcare product to dm+d and undertook an investigation into all electronic prescriptions for Hypromellose 0.3% eye drops (10ml) dispensed between June 2022 – September 2023. This investigation is now complete and NHSBSA will apply the correct reimbursement for prescriptions that were incorrectly disallowed. NHSBSA will be sending a letter alongside the Schedule of Payments, notifying affected pharmacy owners of any adjustments. The adjustments will be included in the December 2024 Schedule of Payments (with a payment date of 28th February 2025). The payments will appear as ‘Adjustment drugs‘ and ‘Adjustment fees’ (if applicable), and will be shown as a combined total.  Please note FP10 paper prescriptions for Hypromellose 0.3% eye drops (10ml) endorsed with the Alissa Healthcare brand submitted between June 2022 – September 2023 will not be automatically re-checked by the NHSBSA. 

A high percentage of disallowed items are for drugs, ordered on FP10D forms, not listed in the Drug Tariff Part XVIIA (Dental Prescribing Formulary) from which a Dental Practitioner may order on a prescription. However, a pharmacy owner recently queried why a handwritten dental FP10D prescription for ‘Amoxicillin order powder 3g’ was disallowed by the NHSBSA. The pharmacy owner successfully challenged the disallowed item with NHSBSA who confirmed this item was disallowed in error and applied the necessary payment adjustments. 

How to challenge disallowed items 

To challenge disallowed items returned via MYS portal, pharmacy owners should: 

• Select the ‘Disallowed items’ tab from the MYS landing page,
• Select the item you believe has been disallowed incorrectly,
• Under the image of the item, select ‘Challenge this disallowed item’,
• In the ‘Reason for your challenge box’ enter the reason you believe the item was disallowed incorrectly,
• Enter an email address,
• Select ‘Submit’.  

Once a challenge is successfully submitted, the information is sent directly to the NHSBSA Helpdesk to action. 

If a disallowed item is successfully challenged, NHSBSA will reimburse the item, and any payment adjustments will be reflected in the next Schedule of Payments. If a pharmacy owner remains unsatisfied with outcome of a disallowed item challenge, they can email their query to ds.team@cpe.org.uk for further advice on the matter. 

It is important to note that disallowed items are only held on MYS for a period of 18 months from the date they are first sent to the pharmacy’s MYS portal; if you have not reviewed and challenged any disallowed items before this deadline has passed, these items will be deleted from the system. 

For information on Hypromellose 0.3% eye drops see link to NHSBSA article in the Hints and Tips Issue 53. 

For more information on disallowed items, please refer to our webpage Disallowed Items and our briefing Understanding prescription returns and disallowed items.