According to APhA's Focus newsletter released March 19th, Medicare will drastically cut reimbursement for current diabetes testing supplies. Starting July 1, 2013, the goal is to reduce reimbursement amounts to the national mail-service fee schedule. This means the amount reimbursed will be $22.47 for 100 test strips and 100 lancets. This reduction in reimbursement correlates with the expansion of Medicare's current Durable Medical Equipment into the new Durable Medical Equipment, Prosthestics, Orthotics, and Supplies (DMEPOS). They have initiated their Competitive Bidding Program which apparently "has saved millions for taxpayers and beneficiaries". However, this incredibly low reimbursement means that community pharmacies currently participating in the program may have to consider dropping it. Most community pharmacies are paying more than the proposed reimbursement amount and would constantly be losing money on every transaction. They will have to find a balance between pleasing patients and their bank accounts. Moreover, July 1 will also mark the end to many community pharmacies being able to deliver to Medicare patients that are homebound or live in assisted-living facilities. These patients will now only be able to receive their testing supplies through the mail by companies that have contracts with CMS to provide mail order service. This creates another deficit to community pharmacies who serve assisted-living patients. Not only will this change affect pharmacies, but patients as well. Pharmacists are there to counsel patients, discuss testing strategies, as well as outcomes, and work with physicians to provide the optimal treatment plans. This will no longer exist. Yes patients will be receiving their diabetes testing supplies cheaper, but their optimal outcome may decline.
This change will have a severe impact on the community pharmacy I am currently working in and we will have to decide if we wish to continue the program or not. Final decisions have to be made by April 15 of this year. We also offer diabetes education services, but the reimbursement changes for these services is currently unknown. Many community pharmacies may be opting out of the program altogether and the impact on patients is yet to be established. Right now it is just a waiting game.
Saturday, March 23, 2013
Wednesday, February 27, 2013
TakeAway Program updates
This week the Iowa Pharmacy Association (IPA) wrote their weekly newsletter. One of the topics they discussed was the new DEA regulations that involve the current TakeAway program. TakeAway is a service free to everyone that allows people to get rid of their unused or expired medications in a responsible way. People can bring any non-controlled medications to a participating pharmacy and have them disposed of for free.
The DEA's new guidelines propose to allow controlled substances to be taken away as well. However, they wish to limit the entire program to law-enforcement agencies only, meaning community pharmacies would no longer be able to participate. According to the IPA newsletter, there are over 440 participating pharmacies across the state of Iowa. The DEA's concern is that pharmacies are not capable of protecting the take-away medications, especially controlled substances, in the meantime before they are sent to their final disposal site. The new regulations would still allow pharmacies to partner with local law-enforcement agencies to host TakeAway events, but would not be able to advertise their pharmacy as a collection site. IPA wrote back to this proposal and stated that, "...the proposed regulations create additional burdens on local law
enforcement agencies, when community-based pharmacies could play a greater role in
controlled substance collection events."
The other key regulation IPA had concerns over was the receptacle the DEA has chosen as the only way to store TakeAway medications. As it currently stands, the receptacles are sealable boxes with a non-removable inner liner. When these containers are full, they are sealed and then shipped back to Sharps Compliance, Inc. for incineration. The DEA now wants only containers with a removable inner liner that would allow for their collection. They propose to have the inner liner removed from the receptacle and collected for disposal under the witness of 2 other authorized employees. The inner liner should then be destroyed promptly or stored at the collector's site until it can be disposed in accordance to current regulations. The DEA also wants the outer liner to be securely fastened to a permanent structure so that is cannot be moved. IPA is suggesting that the guidelines would also allow for " the container to be pad-locked to a secure structure" so that pharmacies wouldn't have to completely install a kiosk or station to allow for the new receptacle.
The DEA will now have time to review all suggestions and comments and make changes if they wish.
The DEA's new guidelines propose to allow controlled substances to be taken away as well. However, they wish to limit the entire program to law-enforcement agencies only, meaning community pharmacies would no longer be able to participate. According to the IPA newsletter, there are over 440 participating pharmacies across the state of Iowa. The DEA's concern is that pharmacies are not capable of protecting the take-away medications, especially controlled substances, in the meantime before they are sent to their final disposal site. The new regulations would still allow pharmacies to partner with local law-enforcement agencies to host TakeAway events, but would not be able to advertise their pharmacy as a collection site. IPA wrote back to this proposal and stated that, "...the proposed regulations create additional burdens on local law
enforcement agencies, when community-based pharmacies could play a greater role in
controlled substance collection events."
The other key regulation IPA had concerns over was the receptacle the DEA has chosen as the only way to store TakeAway medications. As it currently stands, the receptacles are sealable boxes with a non-removable inner liner. When these containers are full, they are sealed and then shipped back to Sharps Compliance, Inc. for incineration. The DEA now wants only containers with a removable inner liner that would allow for their collection. They propose to have the inner liner removed from the receptacle and collected for disposal under the witness of 2 other authorized employees. The inner liner should then be destroyed promptly or stored at the collector's site until it can be disposed in accordance to current regulations. The DEA also wants the outer liner to be securely fastened to a permanent structure so that is cannot be moved. IPA is suggesting that the guidelines would also allow for " the container to be pad-locked to a secure structure" so that pharmacies wouldn't have to completely install a kiosk or station to allow for the new receptacle.
The DEA will now have time to review all suggestions and comments and make changes if they wish.
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