Medicare

Pharmacy Can Now Temporarily Enroll as an Independent Clinical Diagnostic Laboratory with Medicare

Over ten thousand Pharmacies have a CLIA Certificate of Waiver.  Most of these Pharmacies have been providing CLIA waived testing as a cash service only, increasing revenue and helping to offset dropping reimbursements and DIRS. But earlier this month,  CMS issued an MLN Matters Article allowing Pharmacies with CLIA Certification already enrolled in Medicare to fast-track a temporary enrollment as an independent clinical diagnostic laboratory to help combat the spread of COVID-19 during the public health emergency. Pharmacies will need…

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COVID-19 and Pharmacy

COVID-19.  We all know what it is by now – no need to explain further.  For specific information about COVID-19 from the experts, please visit the CDC website, Coronavirus Disease 2019 (COVID-19). In this blog, we will cover regulations and actions your Pharmacy can take to help your staff, patients, and community stay healthy.  We will also share links to various websites with relevant information for Pharmacy. COVID-19 and HIPAA For the most part, the HIPAA Rules remain the same,…

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Medicare Compliance for Refills

Are you Billing Medicare Part B for Blood Glucose Testing Supplies and other items that are refilled on a recurring basis? If you are, Medicare has some new rules and clarified some older ones. These apply to ALL suppliers, whether accredited or not. Pharmacies are required to contact the beneficiary or designee regarding refills. This must take place no sooner than 14 calendar days prior to the refill due date and you  may not dispense the item to the beneficiary…

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Medicare Audits Are On the Rise

In recent Medicare Audits, over 80% of glucose testing supplies and nearly 70% of nebulizer and nebulizer solutions claims were denied.  This resulted in BILLIONS of dollars being recouped from Medicare Suppliers and providers. As a Pharmacy Owner, are you prepared if an Auditor comes to your door? When working with clients, I let them know there are several things that they can do in their pharmacy help prevent the clawback of  hard earned revenue. Be sure you are in Compliance with all 30 Medicare Supplier…

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NSC Site Visit vs. Accreditation Survey

Do you know the difference between an NSC Site Visit and an Accreditation Survey? As a Medicare Part B Supplier you will go through periodic onsite surveys by the National Supplier Clearinghouse and your Accreditation Organization. These two types of surveys are separate and distinct from one another and not allowing either to take place could have negative effects on your ability to bill Medicare. Confused? No worries, many Medicare Part B Suppliers are because they have so many different surveyors coming in to…

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