NACDS, NCPA Urge Doctors to Enroll Now in Medicare's PECOS System to Preserve Patient Access to Durable Medical Equipment

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National Community Pharmacists Association

Jul 14, 2010, 04:17 ET

ALEXANDRIA, Va., July 14 /PRNewswire-USNewswire/ -- In a joint call to physicians across the country, the National Association of Chain Drug Stores (NACDS) and the National Community Pharmacists Association (NCPA) are urging doctors to enroll or update their record in the Medicare Provider Enrollment, Chain and Ownership System (PECOS) being implemented by the Centers for Medicare & Medicaid Services (CMS).

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This week NACDS and NCPA faxed an urgent plea to more than 62,000 doctors' offices, asking them to enroll or update their enrollment in PECOS to ensure that Medicare beneficiaries can continue receiving diabetes testing supplies and other essential Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) from local pharmacies. According to CMS, there are 26,000 pending PECOS enrollment applications for physicians and a few thousand more for non-physician providers.

"Community pharmacists support appropriate efforts to ensure that Medicare dollars are spent wisely, but beneficiaries' access to local pharmacies for their legitimate health care needs must be protected," said NACDS President and CEO Steven C. Anderson, IOM, CAE and Douglas Hoey, RPh, NCPA Acting Executive Vice President and CEO. "We commend CMS for striking the right balance by not implementing changes that would automatically reject claims based on orders, certifications, and referrals made by providers who have not had their applications approved by July 6, 2010. Community pharmacists report that as many as 30 percent of DMEPOS claims are being rejected. That's a clear warning sign supporting CMS' delay of the July 6th PECOS date. We urge all doctors to enroll or update their record in PECOS now to ensure their patients can continue to have uninterrupted access to essential medical products at their local pharmacies."

Starting July 6, 2010, federal regulations require that providers who order or refer durable medical equipment and supplies be enrolled in PECOS for reimbursement claims to be processed. On June 30, just before the regulation took effect, CMS announced that the agency will not implement automatic rejections of claims based on providers who have not had their PECOS enrollment approved by July 6th. On July 6, NCPA proposed changes to CMS as the agency prepares to issue a final regulation outlining its approach to enforcing the PECOS requirements. On July 2, NACDS also submitted comments to CMS seeking changes to streamline and improve the PECOS process.

"We are writing to urge you to soon take action to enroll or update your record in the Medicare Provider Enrollment, Chain and Ownership System so that you have a CMS-approved record in the PECOS system," the groups wrote in the fax alert under the banner of the Coalition for Community Pharmacy Action. "This is an important step on behalf of your patients, as there is a chance that CMS may ultimately deny the claims for the Medicare Part B covered items and services that you prescribe (such as diabetes testing supplies and monitors, canes, crutches, and other medical equipment)."

The National Association of Chain Drug Stores (NACDS) represents 154 traditional drug stores, supermarkets, and mass merchants with pharmacies – from regional chains with four stores to national companies. NACDS members also include more than 900 pharmacy and front-end suppliers, and over 70 international members from 24 countries. Chains operate 37,000 pharmacies, and employ more than 2.5 million employees, including 118,000 full-time pharmacists. They fill more than 2.5 billion prescriptions annually, which is more than 72 percent of annual prescriptions in the United States. The total economic impact of all retail stores with pharmacies transcends their $815 billion in annual sales. Every $1 spent in these stores creates a ripple effect of $3.82 in other industries, for a total economic impact of $3.11 trillion, equal to 26 percent of GDP. For more information about NACDS, visit www.NACDS.org.

The National Community Pharmacists Association (NCPA®) represents America's community pharmacists, including the owners of more than 22,700 independent community pharmacies, pharmacy franchises, and chains. Together they represent an $88 billion health-care marketplace, employ over 65,000 pharmacists, and dispense over 40% of all retail prescriptions. To learn more go to www.ncpanet.org or read NCPA's blog, The Dose, at http://ncpanet.wordpress.com.

SOURCE National Community Pharmacists Association