A Message from CMS on Voluntary Terminations

DMEPOS suppliers must submit a completed CMS-855S application to reactivate billing privileges that were voluntarily terminated. For suppliers that voluntarily terminated due to the accreditation/surety bond requirement, billing privileges will be effective the date that the application has been processed by the NSC.

Senate Does Its Part

The Senate has passed HR 3663, the pharmacy DME accreditation extension deadline. Under the bill, which is now headed to President Obama for signature, the new pharmacy accreditation deadline will be January 1, 2010. As stated, however, we hope that the health care reform bill enacted before that time will include some exemption for pharmacies from the accreditation requirements.

The information sent to members on Friday, which is based on NCPA discussions with CMS, continues to provide the best advice to pharmacies on how to proceed in billing for Medicare DME.

Special thanks go to Senators Baucus, Grassley, Tester and Brownback for all their help on this issue.

October 2009 Average Sales Price (ASP) Files Now Available

The October 2009 ASP pricing files and crosswalks are now available for download from the Centers for Medicare & Medicaid Services.

Exemption Gains Momentum on the Hill

The National Federation of Independent Business (NFIB), National Rural Health Association (NRHA), American Association of Diabetes Educators (AADE), and the Diabetes Access to Care Coalition (DACC) have joined the National Community Pharmacists Association (NCPA) in urging Congress to exempt community pharmacies from the Oct. 1 accreditation and surety bond requirements needed to continue providing Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) to Medicare patients.

Keep your fingers crossed!

What Did Learn at the PAOC Meeting?

What did I learn at the June 4 CMS/PAOC meeting? That there are NO exceptions to DMEPOS accreditation. This includes pharmacists selling only diabetes supplies and unaccredited suppliers serving as diabetes supply subcontractors. All must be accredited by September 30, 2009.

Update Your NSC Files

UPDATE YOUR NSC FILES: DMEPOS supplier standard # 2 requires ALL suppliers to notify the National Supplier Clearinghouse (NSC) of any change to the information provided on the Medicare enrollment application (CMS-855S) within 30 days of the change.

DMEPOS suppliers should use the 3/09 version of the CMS-855S and should review and update:
• The list of products and services found in section 2.D;
• The Authorized Official(s) information in sections 6A and 15; and
• The correspondence address in section 2A2 of the CMS-855S.

This is especially important for suppliers who will be involved in the Medicare DMEPOS Competitive Bidding Program. These suppliers must ensure the information listed on their supplier files is accurate to enable participation in this program.

Information and instructions on how to submit a change of information may be found on the NSC website (http://www.palmettogba.com/nsc) and by following this path: Supplier Enrollment/Change of Information/Change of Information Guide.

Fraud is Fraud and It Hurts Us All

Pharmacy fraud is “unhealthy” for our industry. CMS has trouble distinguishing independents from other HME dealers when it comes to DMEPOS fraud. So I’m more than a little concerned when Florida Attorney General Bill McCollum recently announced a guilty verdict against a former Miami pharmacist for stealing over $1.3 million in prescription drugs from the Florida Medicaid program….and so should you!