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July 2006

CURRENT EVENTS
 
DME SITUATION SYNOPSIS
"2003    The Medicare Modernization Act of 2003 included Accreditation and Competitive Bidding requirements for "anyone wishing to bill Medicare Part B". This means that of the 107,000 Medicare Part B providers all would have to become accredited by 2007 per this statute.
Industry #'s on providers state that about 6-8,000 of all providers are accredited leaving 99-100,000 providers at risk without accreditation. Pharmacies are included in both numbers although the % accredited is even lower than 6-7%

Nothing much was said until September 2005

2005    September - The committee that advises Medicare suggested that they tie accreditation to Competitive Bidding markets and phase it in over 2007-2009.  Everyone relaxed thinking they caught a breather.

2006    April - Medicare issued a 203 page report detailing their latest "rules".  This included non-specific rejection of the committee's 9/05 recommendation and reiteration that EVERYONE wanting to bill Medicare Part B would need to be Accredited in 2007


Medicare has not given a specific date in 2007 for Accreditation to kick in.  Speculation is that it WON'T be 1/1/07 but it could be anytime.  To change it from 2007 would require the law to be amended or some other Act of Congress and there isn't anything in the works to do this. Many groups including NCPA are fighting on our behalf to exempt small DME suppliers, but in the mean time Keystone is working with two different organizations to help our stores prepare for accreditation.  Just getting ready for accreditation will cost $2500 and then the accrediting groups (JCAHO, ACHC, and CHAP) charge between $3500 & $10,000 based on the size of the company (how many home/rental patients).  If you fail the accrediting inspection, you must reapply & pay the above fees again ­ so we are looking closely at companies that will assure that you are properly prepared.

We are also looking into forming a network for competitive bidding through the Federation of Pharmacy Networks.
More information to follow..

Pennsylvania Immunization Update:
The State Board of Pharmacy now has the application for the authorization to provide immunizations available on their website ­ http://www.dos.state.pa.us
Three important things to note:
1 You must first renew your Pennsylvania Pharmacist license through 2008
2 You complete page 1 of the application and mail to the State Board with your copy of your current CPR certificate & $30 fee (CPR classes available at PPA conference in August)
3 You complete top of page 2 & send it to the course provider for your immunization Course, who must complete it & return it to State Board (Also available from PPA)

 
PACE
 
With the signing of SB1188, the PACE/PACENET program has begun their efforts to combine program benefits with Medicare Part D.  Letters to the PACE/PACENET cardholders were mailed beginning Wednesday, July 19, 2006. Recognizing that PACE/PACENET cardholders may present these documents to PACE pharmacists as early this Thursday, we are providing pharmacy organizations with this information by e-mail to enable them to inform their members and/or employees.  The Program also intends to include sample letters with the PACE Remittance Advice of this Friday, July 21.  
 
We are hopeful that the documents will assist you in answering any questions you may receive from clients or constituents.  But, there are three main points that we would like you to convey:
1) Individuals are NOT losing their PACE/PACENET benefits nor are they diminishing in any way,
2) The program would like the individual to accept the Part D plan it selected for the individual, unless they are already enrolled in another Part D plan.
3) Individuals should call the PACE toll-free number at 1-800-225-7223 if you cannot answer their questions from the guidance provided on the documents.
 
Thank you for your assistance.
 
The PACE Program
 
PACE will save about $100 million dollars per year and promises to use these savings to expand the benefits.  Of course Pharmacy will see lower reimbursements from the Part D plans so we have suggested that they use some of their savings to increase Pharmacy Reimbursements ­ No response heard or expected.
PaceNet patients will no longer have a $40 deductible per month; it will be replaced by them paying for their Medicare Part D plan which is $10-$15 lower per month.  Rx's not covered by their Part D Plan, will be covered by PACE or PaceNet.
 
 
We are still recommending the CCRX Plan which does not offer a mail-order option and has better reimbursements, as well as a MTM program in place.  CCRX is one the 6 approved plans from PACE.


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