Congress works to ease Medicare DME restrictions
WASHINGTON —A new move is afoot in Congress to eliminate barriers to the sale of Medicare Part B durable medical equipment, prosthetics, orthotics and supplies by retail pharmacies.
In a bipartisan gesture on behalf of the pharmacy industry, two U.S. senators have introduced legislation that would exempt pharmacies from federal requirements that they post $50,000 surety bonds in order to participate in the Medicare Part B market for DMEPOS. The legislation, sponsored by Sen. Jon Tester, D-Mont., and Sen. Pat Roberts, R-Kan., serves as a companion bill to a similar measure in the House of Representatives, known as H.R. 1970, or the Preserve Patents Access to Reputable DMEPOS Providers Act of 2009.
The National Community Pharmacists Association welcomed the move. “This legislation is important to maintaining patient access to essential medical supplies, such as diabetes testing strips,” said NCPA EVP and CEO Bruce Roberts in a statement issued May 4. “It allows patients to continue relying on their trusted local pharmacies as a one-stop shop where prescription drugs, medical advice and supplies are available, and health outcomes are maximized. We deeply appreciate the leadership of Sens. Jon Tester and Pat Roberts and their continued efforts to help pharmacists continue to play a vital role in the healthcare chain.”
For roughly three years, chain and independent pharmacies have fought to head off new and more stringent rules from the Centers for Medicare and Medicaid Services governing the sale of DMEPOS to Medicare beneficiaries. As originally proposed by CMS in 2006, those rules would require retail pharmacies to bid competitively with other outlets for the right to sell and distribute supplies under Medicare Part B, even including diabetes-testing strips. The new rules also called for pharmacists to be certified for the sale of DMEPOS and for the establishment of a surety bond requirement for anyone engaged in the sale of the products.
Since those regulations first were proposed, Congress has acted to ease the requirements somewhat by passing the Medicare Improvements for Patients and Providers Act, which excludes diabetes-testing supplies from the new competitive bidding requirements. CMS, however, has responded with interim final rules that effectively could expand competitive bidding to again include diabetes supplies sold at retail, and also has proposed including diabetic supplies in a Medicare mail-order program.
In addition, CMS has issued a DMEPOS final rule that requires pharmacies to obtain a surety bond to continue selling DMEPOS by Oct. 2.
In response, both the NCPA and the National Association of Chain Drug Stores have raised new alarms and renewed pleas to Congress to set aside the new requirements. “The bond requirement should not apply to pharmacists, who are already subject to state regulations and are not associated with violation,” Roberts said.
“Fourteen other medical providers are already exempted from this time-consuming and expensive requirement, and this bill would add pharmacists to that list. NCPA encourages the Senate and House to move these bills in an expeditious fashion. This will ensure patient access to medical supplies is not endangered,” Roberts added.
NACDS also has lobbied Congress for relief from the new rules. In testimony earlier this year to the House Committee on Small Business’ Subcommittee on Rural Development, Entrepreneurship and Trade, NACDS warned that “expansion of the competitive bidding program to include diabetic supplies sold at retail pharmacies or CMS’ plan to include diabetic supplies in the national mail-order program could limit participation by pharmacies and reduce diabetic patients’ access to life-saving supplies and services.”
In addition, noted NACDS, “as CMS moves forward with the first round of competitive bidding, it is critical that contract suppliers’ marketing practices be subject to strict oversight by CMS, and any communication to diabetic patients contain information about the continued availability of diabetic supplies at retail pharmacies.”
“We urge Congress to consider the competitive bidding program within the context of a broader set of difficulties pharmacies and patients face in the DMEPOS program,” added the organization in a letter to the subcommittee. “CMS’ recent initiatives, such as the requirement for pharmacies to obtain accreditation and a surety bond in the amount of $50,000 per location, create significant administrative and financial burdens for pharmacies, resulting in the likelihood of beneficiary access difficulties.”
CVS opens Beauty360 No.3 in one of its original Project Life stores
NEW YORK — If anyone thinks that CVS has recast itself solely as a healthcare company, given its string of acquisitions in recent years — particularly, Caremark and MinuteClinic — they probably haven’t seen a Beauty360 store yet. In fact, standing in the middle of one of these 3,000 sq.-ft., high-end beauty boutiques, you might have a hard time recognizing you were in a CVS store at all.
Beauty360 is the culmination of the long-time vision and an awful lot of hard work on the part of several key individuals, most notably, CVS’ top merchant Mike Bloom, VP beauty merchandising Cheryl Mahoney, senior beauty category manager Mary Lou Gardner and Mike LePage, director, retail innovations and store design. Importantly, it is also a very bold statement that, for as much energy as CVS Caremark devotes to driving solutions that save lots of money for big payers of health care, it is very much still focused on its stores, and using other areas beyond health and wellness to spark innovation and create reasons for customers to shop their stores.
You want to talk about growing the market basket? How about adding a whole other basket? With prices on many items topping $100, Beauty360’s contribution to overall store profitability is palpable. According to CVS executives, sales in the two other locations the company operates in Mission Viejo, Calif., and Washington, D.C., are well ahead of expectations.
And why wouldn’t they be? No woman in her right mind, with at least a minute or two to spare, isn’t going to check out Beauty360 — particularly in the ritzy neighborhoods the chain is putting the stores in. The average household income in Mission Viejo is roughly twice the national average; in terms of shopping, Fodor’s calls Dupont Circle “a younger, less staid version of Georgetown — and almost as pricey”; and the newest Beauty360 in Ridgefield, Conn., is surrounded by seven-figure homes. Bloom says CVS is planning to a whole bunch of them into the former Longs stores it is currently converting, which includes many more posh areas to pick from.
With just 30 of the stores planned by the end of the year, and about 50 by this time next year, it likely will be a while before the impact of Beauty360 begins to be seen in CVS’ earnings. In the meantime, you can expect sales per square foot to balloon in the stores that share a roof with a Beauty360.
Beauty360 is an important message to its competitors that CVS hasn’t forgotten about the importance of creating excitement in its stores.
SDI launches iPhone, iPod application for allergy sufferers
NEW YORK The addition of SDI’s Pollen.com allergy applications to the growing number of iPhone/iPod touch-friendly, health-related applications is just the latest example of how an e-health evolution is more and more becoming a part of America’s daily lexicon.
Already, there are more than 100 health-related applications available for the Apple products, including FDA for iPhone and WebMD Mobile. According to Apple COO Tim Cook, those apps are available to some 37 million users — that’s how many iPhones and iPod touches are currently on the market.
Concerned about what exactly those food additives in your favorite snack are? There’s an app for that. Worried about your blood pressure or heart rate? There’s an app for that. Want to know what your blood-sugar level means? There’s an app for that, too.
Indeed, while SDI was preparing for its official Pollen.com iPhone app launch, two Northwestern University teams took home the top two prizes awarded in the Diabetes Mine Design Challenge last week. The challenge? Develop an iPhone app that diabetics could use to help manage their condition.
Next month, Apple plans to release an updated iPhone 3.0 with support for Bluetooth-enabled medical peripheral devices, like Johnson & Johnson’s LifeScan glucometer. And while Apple is updating its iPhone capabilities, Palm will be introducing its Palm Pre, slated to debut June 6 on the Sprint network. The Palm Pre is expected to give Apple’s iPhone a run for its money, but at the very least, it’ll open the door of health-related mobile apps to that many more users.