Rx: No need for bond

ALEXANDRIA, Va.--The National Community Pharmacists Association (NCPA) told CMS in a February letter that the continued “drip” of Medicare requirements - most recently, the surety bond requirement - makes it difficult for independent pharmacists to stay in the program.

In a letter to CMS Acting Administrator Charlene Frizzera, the NCPA stated that pharmacists are licensed healthcare providers overseen by state pharmacy boards and should be exempt from the bond regulation.

“We are hopeful the new administration will look more favorably on the role of the pharmacist in the healthcare system and the value we bring to the table,” said John Coster, senior vice president of government affairs for NCPA. “Part of doing that is recognizing that pharmacists are health professionals like other professionals (such as physicians).”

Per the requirement, DMEPOS providers must obtain a $50,000 surety bond for each national provider identifier (NPI) by Oct. 1, 2009.

The added expense could lead small pharmacies that do limited amounts of DME and diabetes supplies to opt out of Medicare, says Coster. That could lead to access problems for patients, especially diabetics, he said.

“The patient with diabetes often comes to the pharmacist for the whole range of services, from drugs to testing supplies to sugar free products,” he said. “If we are not able to provide for these folks, they may have to travel a long way to another accredited provider.”

CMS has said that patients can obtain necessary supplies through mail order. That's fine if it's what the patient wants, said Coster.

“It should be an option, but mail order mandates (hamper) the freedom of the patient to choose their own provider,” he said. “It's better when they feel like they have a direct relationship with their pharmacist.”

The National Association of Chain Drug Stores and the Food Marketing Institute coauthored the letter.