Pharmacy groups urgently seek relief as Medicare DMEPOS deadline looms

9/9/2009

WASHINGTON A coalition of major pharmacy and retail groups urgently sought help from Congress late Tuesday as a deadline looms for the sale of medical equipment and supplies by community pharmacies.

Pharmacy retailers are faced with early October deadlines that will force them to gain accreditation and purchase a surety bond in order to continue selling durable medical equipment, prosthetics, orthotics and supplies to seniors covered by Medicare Part B. Those requirements are imposed by the Centers for Medicare and Medicaid Services, a division of the U.S. Dept. of Health and Human Services, will throw up daunting hurdles that will block many pharmacies from continuing to participate in the sale of medical supplies under Part B, industry advocates warn.

Under CMS’ new regulations, suppliers of DMEPOS will have to obtain accreditation by Oct. 1 to remain in the Medicare Part B business. Worse, they’ll have to post a $50,000 surety bond per location by Oct. 2 in order to dispense DMEPOS and Part B medications to Medicare patients.

In response, four groups – the National Association of Chain Drug Stores, National Community Pharmacists Association, Food Marketing Institute and National Alliance of State Pharmacy Associations – are appealing directly to ranking members of the House and Senate for legislative relief. Leaders of the four associations sent letters to U.S. Senate Finance Committee Chairman Max Baucus, D-Mont., and Ranking Member Charles Grassley R-Iowa, and to the leaders of the U.S. House Ways & Means and Energy and Commerce Committees urging action to allow pharmacies to continue selling Medicare Part B supplies.

At stake, said the pharmacy leaders, is “Medicare beneficiaries’ access to their necessary medications and durable medical equipment and supplies, particularly diabetes testing supplies, from their trusted community pharmacies.

“We support efforts to curb fraud and abuse in the Medicare program; however, these costly requirements will reduce beneficiaries’ access to prescribed drugs and supplies through their community pharmacies and could cause disruptions in their healthcare,” noted the groups. “Community pharmacies and pharmacists are the most readily accessible healthcare providers and are uniquely positioned to assist Medicare beneficiaries with their durable medical equipment needs, particularly for patients with diabetes.”

NACDS, NCPA, FMI and NASPA warned lawmakers that the new requirements would freeze thousands of community pharmacies out of Part B and disrupt patient care.

“According to CMS’ own estimate, over 25,000 suppliers will exit the Medicare program due to these requirements,” the groups noted. “As community pharmacies represent the largest category of Medicare DMEPOS suppliers, unfortunately that number likely includes many community pharmacies who will find these requirements to be cost prohibitive, resulting in many patients being unable to obtain their necessary drugs and supplies.”

The pharmacy advocates reminded lawmakers in their letter that there are two pieces of proposed legislation, Senate bills 511 ad 956, that would conditionally exempt pharmacies from the surety bond and accreditation requirements. “We would ask for your consideration in merging elements of these bills and moving them as a package prior to Oct. 1,” the groups urged.

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