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Pharmacy groups call on Congress to ease DME requirements

In letters to key congressional leaders, the National Association of Chain Drug Stores and other industry groups are urging lawmakers to take action to allow pharmacies to keep selling Medicare Part B durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) before stricter guidelines

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ALEXANDRIA, Va. — In letters to key congressional leaders, the National Association of Chain Drug Stores and other industry groups are urging lawmakers to take action to allow pharmacies to keep selling Medicare Part B durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) before stricter guidelines go into effect next month.

The Centers for Medicare and Medicaid Services (CMS) is requiring suppliers of DMEPOS to get accreditation by October 1 and obtain a $50,000 surety bond per location by October 2 to provide those products and Part B medications to Medicare patients.

NACDS and the National Community Pharmacists Association (NCPA), Food Marketing Institute (FMI) and National Alliance of State Pharmacy Associations (NASPA) on Tuesday sent letters to leaders of the Senate Finance Committee and the House Ways and Means and Energy and Commerce committees that call on Congress to pass legislation that would grant pharmacies a conditional exemption from the surety bond and accreditation requirements.

The groups requested that lawmakers consider merging elements of two Senate bills (S. 511 and S. 956) and two House bills (H.R. 1970 and H.R. 616) and approve them as a package before October 1.

"We support efforts to curb fraud and abuse in the Medicare program; however, these costly requirements will reduce beneficiaries’ access to prescribed drugs and supplies through their community pharmacies and could cause disruptions in their health care," the groups stated in the letters, which were signed by chief executive officers Steve Anderson of NACDS, Leslie Sarasin of FMI, Bruce Roberts of NCPA and Rebecca Snead of NASPA.

"Community pharmacies and pharmacists are the most readily accessible health care providers and are uniquely positioned to assist Medicare beneficiaries with their durable medical equipment needs, particularly for patients with diabetes," they wrote.

The groups noted that more than 25,000 suppliers would exit the Medicare program because of the new requirements, according to a CMS estimate.

"If Congress does not take action before the surety bond and accreditation requirements go into effect, Medicare beneficiaries’ health will be put at unnecessary risk," the pharmacy groups said in the letters. "As community pharmacies represent the largest category of Medicare DMEPOS suppliers, unfortunately that number likely includes many community pharmacies that will find these requirements to be cost-prohibitive, resulting in many patients being unable to obtain their necessary drugs and supplies."

Sens. Jon Tester (D., Mont.), Sam Brownback (R., Kan.) and Pat Roberts (R., Kan.) introduced the S. 511 and S. 956 Senate legislation, while Reps. Zach Space (D., Ohio), Marion Berry (D., Ark.), Jo Ann Emerson (R., Mo.) and Jerry Moran (R., Kan.) introduced the H.R. 1970 and H.R. 616 bills in the House.

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