House delays accreditation requirement for pharmacies

Sunday, October 4, 2009

WASHINGTON - The U.S. House of Representatives passed a bill Wednesday that will push the accreditation deadline for pharmacies to Dec. 31, 2009.

Industry stakeholders expect Sen. Jon Tester, D-Mont., to introduce a companion bill in the Senate this week. It is expected to pass, say stakeholders.

"This is the type of movement that will prevent patients from going to their community pharmacies tomorrow and being told they can't get their durable medical equipment there," said John Norton, associate director, public relations, for the National Community Pharmacists Association (NCPA).

Reps. Zach Space, D-Ohio, and Lee Terry, R-Neb introduced the House bill, H.R. 3663, on Sept. 30, the deadline for HME providers, including pharmacies, to become accredited.

CMS has said that under certain circumstances, pharmacies can continue to bill for DMEPOS:

* If a pharmacy has voluntarily revoked its Medicare Part B billing number or has "stepped down" on their 855S form (indicating that the pharmacy would be providing only Part B drugs but not DMEPOS) and the NSC has not processed your application, you can continue to bill for DMEPOS and Part B drugs. NCPA has secured a commitment from CMS that it will ask the NSC to not process any further pharmacy applications that request a "step" down or voluntarily termination from the program.

* If you have "stepped down" and are waiting for accreditation, CMS has said that your billing privileges exist as of the date on the accreditation certificate.

Pharmacies still need to obtain surety bonds, said Bill Popomaronis, NCPA's vice president of long term and home health care pharmacy services.

"CMS has said that they will give some flexibility to pharmacies on getting the surety bonds in October--days, not weeks," he said. "Get it in as soon as you can."

The NCPA estimates that only about 10,000 community pharmacies have obtained accreditation.

By delaying the deadline, the NCPA and other stakeholders buy themselves more time to get pharmacies exempted from the requirement, said Norton. Two bills introduced earlier this year that seek an exemption have been included in broader healthcare reform bills.

"There seems to be bipartisan consensus that Congress should deal with this," said Norton.