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NACDS: PECOS date change could curtail pharmacy access

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ALEXANDRIA, Va. — A date change proposed by the Centers for Medicare & Medicaid Services (CMS) for physician and nonphysician practitioner enrollment in the Medicare Provider Enrollment, Chain and Ownership System (PECOS) could impact patient access to pharmacy services, according to the National Association of Chain Drug Stores.

NACDS said Wednesday that CMS last month issued an Interim Final Rule moving up the PECOS implementation date by six months to July 6, 2010, from Jan. 3, 2011. The new date puts pharmacies and other Medicare Part B suppliers at risk for having their claims denied if a beneficiary’s prescriber is not enrolled or not correctly enrolled in PECOS.

Steve Anderson, president and chief executive officer of NACDS, noted that the accelerated date for PECOS enrollment may cause service disruptions for Medicare Part B patients.

"The new PECOS enrollment date poses a threat to pharmacy-provided health care services," he said in a statement. "NACDS members are already confronting 30% rejection rates on their Medicare Part B claims due to the fact that providers are either unaware or not properly enrolled in PECOS. NACDS will continue efforts to lessen any PECOS-related disruptions or delays for patients and beneficiaries."

NACDS said it has worked to alert prescribers of the new date and notified congressional leaders on the potential for service disruptions for Medicare beneficiaries. The association also plans to submit comments to CMS citing concerns about this change.

"The new date — less than one week away — may reduce patients’ access to pharmacy-provided counseling, medical equipment and supplies, such as diabetes testing strips and monitors, canes and crutches, and have negative consequences for patient health and medication adherence," Anderson stated. "We urge CMS to reinstate the Jan. 3, 2011, enrollment date."

Carol Kelly, senior vice president of government affairs at NACDS, last week sent a letter to House Energy and Commerce Committee leaders Rep. Henry Waxman (D., Calif.) and Joe Barton (R., Texas) to express the urgency of the matter to lawmakers.

"Chain pharmacies have worked with CMS and done outreach to the physician community to address the need for prescribers to be properly enrolled in PECOS so that we continue to serve our patients. Nonetheless, it is important to note that pharmacies have no control over whether a prescriber is properly enrolled in the PECOS system," Kelly wrote.

"We are deeply concerned with the likelihood that patients will suffer service disruptions despite the best efforts of community pharmacies to assist them," she added.


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