Get letters signed, sealed and returned

Tuesday, November 23, 2010

BALTIMORE - Pharmacies that received letters from the National Suppliers Clearinghouse (NSC) have until Jan. 1 to sign and return them to confirm that they are indeed exempt from accreditation requirements, CMS officials announced during an Oct. 13 Special Open Door Forum.

The letters were due to be sent in October to unaccredited pharmacies. Accredited pharmacies, on the other hand, won't receive the letter by mail; they must download it from the NSC website,, complete it and return it if they wish to request the exemption.

The Affordable Care Act, passed earlier this year, included an accreditation exemption for certain pharmacies.

Pharmacies that wish to be exempted must meet three criteria: The pharmacy's total billings for DME must comprise less than 5% of total sales for the previous three calendar years; they must have been enrolled as a DME supplier with a provider number for at least five years; and they must not have had any federal adverse action in the past five years.

Accredited pharmacies that plan to let their accreditation expire between now and January should tread carefully, said Sandra Bastinelli, CMS's senior technical adviser for the Center for Program Integrity.

"If you choose to let your accreditation expire, and it is determined that you do not meet the criteria, you will be dis-enrolled and you will not be able to bill for those DME effective Jan. 1, 2011," she warned.