Pharmacists Still Looking for Accreditation Exemption

ATLANTA — Earlier this year, some pharmacies doing
Medicare DMEPOS business got an extra three months to get
accredited, courtesy of Congress, and didn’t have to meet the
mandatory Oct. 1 accreditation date. But as the Dec. 31 extension
deadline looms, the National Community Pharmacists Association said
it is working to get that deadline extended further — and to
get the requirement for pharmacies eliminated entirely.

NCPA officials said that while the accreditation regulation is
supposed to prevent fraud, there is little evidence that
pharmacists perpetrate these crimes. John Norton, associate
director of public relations for the organization, pointed out that
pharmacists are already subject to regulations and fines at the
state level. Despite exempting 17 other medical providers, CMS is
requiring pharmacists to undergo what the NCPA calls a
“time-consuming, expensive, and redundant” process to continue
selling DMEPOS items.

Citing a recent survey, Norton added that pharmacy owners might
determine they cannot justify the cost and time commitment of
accreditation, causing them to stop selling medical products and
hampering patient access.

“Congress is helping solve this problem,” said Norton from the
NCPA’s Alexandria, Va., office. “Provisions exempting pharmacies
from the requirement are included in both health care reforms
bills?the version passed by the House and the version being
considered in the Senate. With the extension almost being over, we
are calling on Congress to extend the accreditation deadline until
March 31 [2010]. This should allow enough time to pass the health
care reform, or to find an alternative way to address this
issue.”

In June, the NCPA estimated that of the 23,000 independent
pharmacies it represents, fewer than 10,000 had begun the
accreditation process.

But according to consultant Mary Ellen Conway, some
pharmacists-those that dutifully jumped through hoops to gain
accreditation-are “very angry” at the prospect of legislators
letting unaccredited pharmacies off the hook.

Conway, president of Capital Healthcare Group, Bethesda, Md.,
said all of the major chains are accredited, and she estimated
about 60 percent of the smaller or single-site operations have
successfully completed accreditation requirements.

“The only pharmacies I’ve been working with this fall are the
ones who were already in the process before [the original Oct. 1
deadline],” said Conway. “I haven’t spoken to anyone who started
the process after the extension. The NCPA made it clear that they
were trying to eliminate the requirement for pharmacies, and it is
my experience that thousands of pharmacies that never started the
process expect that the requirement will be eliminated. Pharmacy
owners I’ve worked with who did what they were required to do are
very angry, and are hoping the exemption does not happen.”

Meantime, Sen. Sherrod Brown, D-Ohio, recently introduced an
amendment to the Senate health care reform bill to remedy what
Norton calls “another unreasonable attempt” to target pharmacies
for DMEPOS fraud.

“Pharmacies would be required to purchase $50,000 surety bonds to sell DMEPOS,
even though 14 other medical providers have been exempted from a
similar requirement,” lamented Norton. “This deadline mirrored the
accreditation one, but market forces provided relief. Insurance
companies have realized that pharmacies are a very low risk, and
have reduced the price to purchase the surety bonds. We are hopeful
[Brown’s amendment] will be adopted and included in any final bill
that emerges from reconciliation with the House.”