Bill Popomaronis, R.Ph., NCPA vice president, home health and long term care pharmacy services, provides his thoughts and explanations on the latest DME information from CMS.
Tuesday, December 23, 2008
Part B Drug Allowables for First Quarter 2009
The Centers for Medicare & Medicaid Services (CMS) has made available the Medicare Part B Drug and Biological Average Sales Price (ASP) Payment Amounts for January 1, 2009 to March 31, 2009, on the CMS website. The files are located in the "Downloads" section of this web page.
Monday, December 15, 2008
Accreditation Guidelines for Pharmacy – READ THE FINE PRINT!
The National Supplier Clearinghouse has provided the following information for pharmacists NOT supplying DMEPOS...
CMS has deemed that suppliers providing drugs and pharmaceuticals only are not required to be accredited to obtain/maintain Medicare billing privileges. If suppliers bill for DMEPOS outside of pharmaceuticals, including products to administer drugs or pharmaceuticals, accreditation will be required to maintain Medicare billing privileges.
Pharmacy suppliers must update their file with the National Supplier Clearinghouse (NSC) by choosing "Pharmacy" as the supplier type in section 2B, and selecting "Drugs/Pharmaceuticals" only in section 2C of the CMS-855S enrollment form. All other products/services must be removed to assume the accreditation exemption.
Suppliers found to be in violation of this rule by billing for other products or services will be subject to appropriate actions up to and including revocation.
CMS has deemed that suppliers providing drugs and pharmaceuticals only are not required to be accredited to obtain/maintain Medicare billing privileges. If suppliers bill for DMEPOS outside of pharmaceuticals, including products to administer drugs or pharmaceuticals, accreditation will be required to maintain Medicare billing privileges.
Pharmacy suppliers must update their file with the National Supplier Clearinghouse (NSC) by choosing "Pharmacy" as the supplier type in section 2B, and selecting "Drugs/Pharmaceuticals" only in section 2C of the CMS-855S enrollment form. All other products/services must be removed to assume the accreditation exemption.
Suppliers found to be in violation of this rule by billing for other products or services will be subject to appropriate actions up to and including revocation.
Test Your Staff's DMEPOS Billing Knowledge
If you have been billing Medicare for years or are just starting out, stop by the DME MAC A website today and Test Your DMEPOS Billing Knowledge!
The Test Your Knowledge section is available at: http://www.medicarenhic.com/dme/dme_quiz_form.shtml
New quizzes will be released regularly, so check back often.
The Test Your Knowledge section is available at: http://www.medicarenhic.com/dme/dme_quiz_form.shtml
New quizzes will be released regularly, so check back often.
Keep an Eye Out for Seniors Experiencing the Holiday Blues
While the holiday season is a festive time for many, it can cause depression for seniors who've lost loved ones or are having health or financial problems.
For some seniors, this despondency can lead to suicide, according to the American Geriatrics Society, which noted that the 2004 suicide rate for Americans over the age of 65 was 14 per 100,000. Considering the current economic crisis, I expect much of the same in 2009.
Many older people don't realize when they're depressed. Seniors need to understand that depression is a medical illness that can be treated and managed. “Toughing it out” may have devastating effects. Pharmacists have an expanded role to play during these stressful times.
It’s hard at times to pick our heads up from the computer screen, especially during flu season, but a pharmacist's job is more than “ putting pills in a bottle.”
A review of the medication profile alerts you if the patient is in treatment already. Ask the patient how they are doing. If you’re an independent pharmacist, your patients already are comfortable talking with you.
Their responses might indicate a need for an antidepressant dosage adjustment, or that a visit to the appropriate health professional is warranted.
And, what about your own Blues? Well, you already know the answer. Patients come first as you have done from the day you opened the door. I know, I did it myself for 25 years.
Be well and Happy Holidays to you all!
For some seniors, this despondency can lead to suicide, according to the American Geriatrics Society, which noted that the 2004 suicide rate for Americans over the age of 65 was 14 per 100,000. Considering the current economic crisis, I expect much of the same in 2009.
Many older people don't realize when they're depressed. Seniors need to understand that depression is a medical illness that can be treated and managed. “Toughing it out” may have devastating effects. Pharmacists have an expanded role to play during these stressful times.
It’s hard at times to pick our heads up from the computer screen, especially during flu season, but a pharmacist's job is more than “ putting pills in a bottle.”
A review of the medication profile alerts you if the patient is in treatment already. Ask the patient how they are doing. If you’re an independent pharmacist, your patients already are comfortable talking with you.
Their responses might indicate a need for an antidepressant dosage adjustment, or that a visit to the appropriate health professional is warranted.
And, what about your own Blues? Well, you already know the answer. Patients come first as you have done from the day you opened the door. I know, I did it myself for 25 years.
Be well and Happy Holidays to you all!
Wednesday, December 10, 2008
Health and Human Services Secretary Blagojevich?
It is alleged that Illinois Gov. Rod Blagojevich, in a charge related to the appointment of a senator to replace Barack Obama, sought appointment for himself as Secretary of Health and Human Services, or a lucrative job with a union, in exchange for appointing a union-preferred candidate.
Regardless of your affiliation, you have GOT to love politics!
Regardless of your affiliation, you have GOT to love politics!
Tuesday, December 9, 2008
But What About the Dollar Menu?
A study found that people given packaged meals were more successful at losing weight than were participants who chose their own portion sizes. Cutting down on portion sizes is the best way to combat the creeping obesity epidemic. Pharmacists can assist patients, especially those with diabetes, in managing weight issues by providing easy ways to measure portions correctly. For example, your fist is equivalent to 1 cup or 8 ounces. Tips such as this endear patients to your pharmacy. Find more and distinguish yourself from the competition.
Monday, December 1, 2008
Make Space for This Product
According to a nationwide survey by the American Association of Diabetes Educators (AADE), only 25 percent of people with diabetes know their HbA1c level, and less than 20 percent have their HbA1c tested regularly. FDA approved, over-the-counter Hemoglobin A1c (HbA1c) tests should have prominent shelf space in your pharmacy's diabetes care department.
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