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Medicare Part B DME Accreditation and Competitive Bidding
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DMEPOS Surety Bond Legislation Introduced

By William Popomaronis, R.Ph.

U.S. Representatives Zach Space (D-OH) and Jo Ann Emerson (R-MO) have introduced H.R. 1970, the Preserve Patents Access to Reputable DMEPOS Providers Act of 2009. The bill exempts pharmacies from having to post surety bonds in order to provide Medicare Part B Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) to their patients. In response, National Community Pharmacists Association (NCPA) Executive Vice President and CEO Bruce T. Roberts, RPh, issued the following statement:

"Community pharmacies want to continue providing their patients access to life-saving supplies and related services - such as diabetes testing strips - through participation in the DMEPOS program. Unfortunately, CMS' regulations require pharmacists to purchase $50,000 surety bonds to guard against fraud where there is no record of impropriety, while 14 other similarly-licensed medical providers have been exempted.

"Representatives Zach Space and Jo Ann Emerson's bill sensibly removes the onerous surety bond costs for pharmacists, which when added to the several thousand dollar costs mandated by the DMEPOS accreditation requirements, are out of proportion with the small percentage that DMEPOS represents for independent community pharmacies' overall revenue. H.R. 1970 places the surety bond payment burden where it belongs - on the backs of those who run afoul of the program. We urge House members to cosponsor H.R. 1970 and move it as quickly as possible so reputable pharmacists won't have to meet these unnecessary requirements."

The Centers for Medicare & Medicaid Services (CMS) issued a DMEPOS final rule that requires pharmacies to obtain a surety bond to continue selling DMEPOS by October 2, 2009. The average independent community pharmacy's DMEPOS-generated revenue only comprises a small percentage of their gross annual sales. In fact, many independent community pharmacies percentages fall well below that threshold.

Fourteen other medical professions are exempted from the surety bond requirement because of their state licensure, expertise and training - all qualities that pharmacists share. In rural and urban areas independent community pharmacies are often the only health care provider that provides access to health care supplies. H.R. 1970 will assure patient access to DMEPOS supplies and the consultation of their community pharmacist.

It's Not Too Late to Give and Get the Flu Shot!

In the U.S., the peak of flu season typically occurs anywhere from late December through March; however, flu season can last as late as May. Each pharmacy visit presents an opportunity for you to talk with your patients about the importance of getting an annual flu shot and a one time pneumococcal vaccination. Protect yourself, your patients, and your family and friends by getting and giving the flu shot. Don't Get the Flu. Don't Give the Flu.

Remember - Influenza and pneumococcal vaccinations and their administration are covered Part B benefits. Note that influenza and pneumococcal vaccines are NOT Part D covered drugs.

Health care professionals and their staff can learn more about Medicare's Part B coverage of adult immunizations and related provider education resources, by reviewing Special Edition MLN Matters article SE0838.


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Fast Facts
 
     
 
  • All Medicare Part B suppliers must be accredited by a CMS-approved Deemed Accreditation Organization by September 30, 2009.
  
   
     
 
Round I & Round II
  
 
  • The Medicare Improvements for Patients and Providers Act of 2008, enacted on July 15, 2008, has delayed DME Competitive Bidding.
  • All associated special accreditation deadlines have been cancelled.
  
 
Important Links:
  
   
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William Popomaronis, R.Ph., is vice president, long term and home health care services for the National Community Pharmacists Association (NCPA). He is also the only pharmacist member of Medicare’s Program Advisory and Oversight Committee (PAOC), which provides advice on the development and implementation of the DME Competitive Acquisition Program.

  
 
  Bayer HealthCare, Diabetes Care, has underwritten the costs of this communication. The information expressed in this communication are the views of NCPA. Bayer is not responsible for the accuracy of the information expressed in this communication. Any questions related to DME Accreditation and/or Competitive Bidding for DMEPOS should be directed to the Centers for Medicare and Medicaid Services or NCPA.  
 
 
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