Drug Topics - April 21, 2008 - (Page 9)

9 NEWS Roundup< < < Government and Law CMS rule will allow more needy patients to stay in existing Medicare plans At present, Medicare Part D patients who use the lowincome subsidy are reassigned to a different drug plan if their existing plan no longer offers zero premiums and they don’t state which plan they want to switch to. Thanks to a new final rule the Centers for Medicare & Medicaid Services has just issued, many more such patients will be able to stay put without having to pay a premium. This improvement is made possible by changes in the way Medicare calculates its regional low-income subsidy benchmarks. CMS estimates that if this rule had been in place for 2008, there would have been 850,000 fewer plan reassignments. The rule will take effect on May 31. May 23, 2007. After receiving complaints from insurers and healthcare organizations, CMS agreed to delay full implementation of the requirement. In a letter sent to more than 70 groups representing prescribers, patients, and other healthcare interests, the National Association of Chain Drug Stores reminded the groups of the coming deadline and urged greater compliance. “Approximately one-third of prescribers do not have an NPI yet,” said NACDS president and CEO Steven C. Anderson. “We want to work with prescribers to achieve universal NPI compliance and ensure that Medicare and Medicaid patients can get their medications.” Medicare fraud lands Miami Medicare billing service owner in jail for 10 years Miami resident Rita Campos Ramirez was sentenced to 10 years in prison for her role in a $170 million scheme to defraud Medicare. As part of her plea, Campos admitted that between October 2002 and April 2006 she owned and operated R&I Medical Billing Inc. that specialized in submitting bills to the Medicare program on behalf of HIV infusion clinics. Campos was sentenced in the U.S. District Court for the Southern District of Florida by Judge Alan S. Gold. In addition to the prison sentence, Judge Gold ordered that the defendant be placed on three years of supervised release following her release from prison; forfeit $207,000, her three homes, and an automobile; and pay $105 million in restitution to the U.S. Department of Health & Human Services. Advocacy groups, NACDS push Congress to pass bill to preserve pharmacy access A coalition of advocacy groups expressed their support for legislation that will help preserve patient access to medications. In a letter to Congressional leaders the groups urged Congress to pass The Fair Medicaid Drug Payment Act (H.R. 3700/S. 1951). The letter was signed by the 60 Plus Association, The American Medical Group Association, Easter Seals, Leukemia & Lymphoma Society, the National Caucus & Center on Black Aged Inc., the National Consumers League, and the National Family Caregivers Association. NACDS president/CEO Steve Anderson commented on the groups’ support of this legislation, stating, “These diverse organizations share the same goal—the need to preserve access to medications for low-income patients. We are pleased to be working together towards this goal and grateful for their support of this crucial legislation.” State and federal legislation toughens rules for Internet pharmacies There’s legislation on both the state and federal levels to make it harder for Internet pharmacies to sell controlled substances without the proper controls in place. On the federal level, the Senate has just passed S.980, a bill to amend the Controlled Substances Act to address online pharmacies. Among other things, it prohibits an online pharmacy from selling a controlled substance over the Internet without a valid prescription. On the state level, Indiana has just passed Senate Bill 302, which requires nonresident pharmacies utilizing the Internet to obtain Verified Internet Pharmacy Practice Sites (VIPPS) accreditation from the National Association of Boards of Pharmacy (www.nabp.net) or an equivalent program approved by the state board of pharmacy before shipping drugs into the state. The law takes effect on July 1. CMS to require NPI on all claims beginning May 23 The Centers for Medicare & Medicaid Services is requiring all pharmacies to submit a prescriber’s National Provider Identification number on all prescription drug claims starting May 23. CMS pharmacy claims filed without NPI numbers after that date may not be reimbursed. The Health Insurance Portability & Accountability Act of 1996 mandated the adoption of unique identifiers for all healthcare providers, which was originally slated to take effect http://www.nabp.net

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Drug Topics - April 21, 2008 Contents The 20 Drug Firms Par Excellence in 2007 Treating Kids with Cough and Cold: Filling the Void Promoting Medication Safety: A Community Outreach Event Scholarship Helps Students Get Into Pharmacy New Products Latest News Roundup

Drug Topics - April 21, 2008

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