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."