NCPA fights ‘improper and unwarranted’ Part B recoupment efforts
WHAT IT MEANS AND WHY IT’S IMPORTANT Independent pharmacy clearly has found its voice.
(THE NEWS: Indie pharmacy applauds move in Congress to end aggressive Part B recoupment efforts. For the full story, click here)
In yet another testament to the growing stature of local pharmacy owner-operators in the endless give-and-take on Capitol Hill, two more members of the majority party in Congress have allied themselves with community pharmacy. How? By demanding that the White House put a stop to aggressive bill-collecting practices by Medicare Part B contractors trying to extract additional funds from retail pharmacies.
In many cases, the bills are for durable medical equipment, diabetic supplies and other health products sold years ago to Part B beneficiaries.
The bill-collection efforts are not only aggressive, said the National Community Pharmacists Association and other pharmacy groups. They’re also improper and unwarranted, they argued.
Medicare DME contractors want to recoup the full costs of products they supplied to retail pharmacies, and according to the NCPA are dunning owner-operated community pharmacies for payment. But it’s all but impossible for those pharmacies to provide a full accounting for products sold to patients who may or may not have been covered through a Medicare Advantage or Home Health Agency at the time of purchase, the NCPA asserted — especially when the Centers for Medicare and Medicaid Services was playing catch-up in processing patient applications for MAs or HHAs. And at any rate, it’s up to the MA or HHA serving the Medicare Part B program to make up any payment discrepancy, the NCPA argued.
At least two influential members of Congress, Democratic Reps. Tammy Baldwin of Wisconsin and Bart Stupak of Michigan, agreed. They drafted a letter to CMS, demanding that the agency put an end to the aggressive collection efforts by contractors, and noting that the services and supplies provided by independent pharmacies to Medicare recipients were “billed in good faith.”
The battle to shield community pharmacies from the DME bill collectors may mark the final legislative campaign for the NCPA’s highly regarded top executive Bruce Roberts, who is retiring this month after nearly nine years as EVP and CEO.
In a statement June 17, Roberts summed up the industry’s position, noting that pharmacists must do what they can to serve patients with the health supplies and services they need, whether or not those patients are covered by Part B, and whatever form that coverage takes. “The DME contractors,” he said, “need to target MA or HHA in their collection efforts and not the pharmacists.”
FDA approves Jevtana
SILVER SPRING, Md. The Food and Drug Administration has approved a new treatment for advanced prostate cancer, the agency said Thursday.
The FDA announced the approval of Sanofi-Aventis’ Jevtana (cabazitaxel), a chemotherapy drug used with the steroid prednisone. The agency said the drug was the first treatment for advanced, hormone-refractory prostate cancer that has worsened during or after treatment with docetaxel, also a chemotherapy drug used in advanced prostate cancer. Hormone refractory prostate cancer happens when prostate tumors continue to grow despite treatments meant to reduce the body’s production of the male hormone testosterone, which helps prostate tumors grow.
“Patients have few therapeutic options in this disease setting,” FDA Center for Drug Evaluation and Research Office of Oncology Products director Richard Pazdur said. “FDA was able to review and approve the application for Jevtana in 11 weeks, expediting the availability of this drug to men with prostate cancer.”
Report: Oregon State Board of Pharmacy declares marijuana as drug with medical use
SALEM, Ore. The makers of the 1930s documentary “Reefer Madness” would be furious at the news, but it likely will come as a relief to people with certain diseases and marijuana law-reform advocates.
The Oregon State Board of Pharmacy voted Wednesday to have marijuana classified as a drug with medical use, according to reports from a local TV station. The decision makes the state to reclassify it as such.
Under the decision, marijuana will be known as a Schedule II controlled substance, meaning that it has high potential for abuse but still has medical benefits. Previously — and still in all other states — marijuana was a Schedule I drug, meaning it had no medical benefits.