Category : Compliance

Pharmacy Compliance shouldn't be a nightmare

Pharmacy Compliance regulations are all around us. And, just when you’re sure you’ve addressed every requirement and best practice suggestion in your pharmacy operations, some government entity or state pharmacy board changes the rules a little bit.

Pharmacy Compliance

It can be overwhelming, but myself and my Director of Compliance wrote an article for the October 2014 America’s Pharmacist that summarizes the latest changes and the most important issues with pharmacy compliance. NCPA members can click here to read “Compliance: It Doesn’t Have to Be a Nightmare.” These are the topics they highlighted:

HIPAA: “What will HIPAA auditors be looking for in your pharmacy?”

FRAUD, WASTE AND ABUSE: “It is important to understand what the Medicare Part C and D plans will be looking for, in addition to appropriate claims data.”

MEDICARE PARTS C & D STAR RATING: Because Medicare is rating the quality and performance of prescription drug plans, those plans are “evaluating individual pharmacies in their networks based on the…criteria that Medicare uses.”

HAZARD COMMUNICATION STANDARD (OSHA): “Basically, employees have the right to know and understand the hazardous chemicals that are maintained and/or used in a workplace.”

MEDICARE PART B and RELATED AUDITS: “A common misunderstanding among pharmacy owners is that, if they filed and received an exemption from the DMEPOS accreditation…requirement, they are also exempt from the Medicare Part B compliance requirements. Not true.”

COMBAT METHAMPHETAMINE ACT OF 2005: “This regulation…outlines the requirement to track the sale of pseudoephedrine and related chemicals…”

QUALITY ASSURANCE (QA) or CONTINUOUS QUALITY IMPROVEMENT (CQI) PROGRAMS: “As QA program requirements will vary from state to state, you must assure your meets the requirements of all your payers, the federal government, and the state.”

Stay tuned! In future blogs, I will be breaking down and giving more detail on each of the topics above.

For more information about the specific changes and pharmacy compliance solutions for your pharmacy, call PRS at 1-800-338-3688 and speak with one of the Specialists. Also, stop back here for additional posts on compliance issues and what you need to know as a pharmacy owner.

compliance puzzle

Compliance and Your Pharmacy

It’s not news that compliance issues are among the biggest worries a pharmacy owner faces today.

With the scheduling of more and more government auditing, it is even more compliance puzzleimportant to be organized and compliant with Fraud, Waste and Abuse, HIPAA, Quality Assurance, and Pseudoephedrine regulations. You must document your monthly check of the exclusion lists and keep all of your licenses and certifications up-to-date. With these audits come steep fines if the pharmacy is found to be out of compliance.

Since June 1, 2013, the Health and Human Services Office of Civil Rights (HHS OCR) has levied fines totaling more than ten million dollars. Many recent articles about HIPAA audits warn that this past year was just the tip of the iceberg and that next year will bring even more substantial penalties and fines. For more information about what the HHS OCR has to say about their future enforcement of HIPAA and the penalties they’ll impose, click here.

I have said it time and again in this blog and at my speaking engagements, YOU, as a pharmacy owner, cannot afford to ignore or put the minimum amount of work into making your pharmacy compliant. The audits are happening and the fines and penalties are considerable.

How do you get and stay compliant, you ask?

Here are four tips that can help you get started.

1. Appoint a staff member that you trust to be your Compliance Officer.
2. Research available software and tools that can assist you in becoming compliant.
3. STAY ON TOP OF IT. There are often updates and changes to the regulations. If you don’t pay attention, you can fall out of compliance.
4. Be sure that your employees are trained on all of the pharmacy’s procedures and that their training is documented.

This seems like a lot of work, doesn’t it? Unfortunately, it can be if you let it. Lucky for you, there are consultants out there that can help. While they won’t do ALL of the work for you, they can DEFINITELY make the work easier.

PRS Pharmacy Services offers COMPLIANCETrack, a new program that puts ALL of the compliance policies and procedures you need at your fingertips. No more going from program to program to keep your compliance up to date. View a short video on this new and innovative program to see how it can make compliance easier and less worrisome so you can spend time where it matters—on your valuable patients.