Pharmacists steal spotlight during accreditation forum

Sunday, January 11, 2009

BALTIMORE - During a Special Open Door Forum last week, it quickly became clear that one group of providers in particular still resists the idea of accreditation: pharmacists.

During the forum, CMS official Sandra Bastinelli said about 25,000 pharmacies have already become accredited, including community pharmacies and chains. Yet, based on the question-and-answer session, there are still plenty of pharmacists who aren't accredited--and they're not happy, in the least, about having to comply with the requirement.

"Why weren't community pharmacists who are doing low volume DME with some diabetic supplies not exempted from this overwhelming program?" asked one pharmacy provider from Pennsylvania.

CMS doesn't have the power to exempt organizations, Bastinelli pointed out. The Medicare Improvements for Patients and Providers Act (MIPPA) lists the eligible professionals and other persons who are exempt from becoming accredited, and pharmacists are nowhere to be seen.

Furthermore, state licensing requirements for pharmacists require them to enroll in the Medicare program as organizations, rather than as individuals. Being able to enroll as individuals would exempt them from the requirement.

In a nutshell, CMS's hands are tied, Bastinelli said.

"This is not a personal affront to pharmacists," she said.

Another pharmacy provider called in, worrying about access in his rural Iowa county. He is not planning to become accredited.

"We do about $20,000 a year and it's going to cost me over $4,000 to get accredited, not to mention the time," he said. "Has CMS considered what they are going to do for my patients that have no other options?"

Beneficiaries will still have access through chain operations or mail order, Bastinelli said.

During the forum, Bastinelli also put the kibosh on a couple of rumors floating around the pharmacy community.

"Individual pharmacists and their staff must go through this process, yet we are told that chains got blanket certification at the corporate level," said one caller. "How do you justify that?"

That's not true, Bastinelli said. Chain pharmacies have to go through the process like everyone else, including unannounced site surveys.

Another caller said he had heard that there was a "more relaxed" application process for providers just billing for glucose test strips.

The application process is the same for everyone, Bastinelli said. However, the fewer covered items you bill, the more simple the survey.