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On May 27, the Centers for Medicare and Medicaid Services will host a second national education conference call to discuss implementation issues for the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Suppliers (DMEPOS) competitive bidding program. During this call, CMS will answer questions on exceptions and situations that may be encountered during implementation.
As the Illinois General Assembly looks forward to a long weekend away from the ongoing dialogue of budgets and State needs, I would like to update you on the efforts of pharmacy to seek passage of meaningful PBM reform legislation. Tight budgets, pressing fiscal needs and the elements of State politics and not to mention the upcoming fall elections have put undue pressure on members of the IL Legislature. In spite of ongoing efforts to pass our PBM legislation it is now quite apparent that the political environment is not one in which many legislators want to engage in debate of any ?contentious? legislation. Last week IPhA fell short of the necessary votes to get HB-5614 out of the Senate Licensed Activities Committee, and it appears that the prevailing sentiment is that we will not have the required votes to move this bill prior to the time for spring adjournment. All parties are hopeful that a compromise budget can be achieved and they can go home soon without the protracted sessions they had last year. The opposition of the PBMs and the lack of understanding by members of the General Assembly have made passage of our original bill all but impossible. Rather, we have determined our best opportunity at this time is to remove the licensure and disclosure elements from the bill and to work on those aspects of the bill that ?directly? impact pharmacy day-to-day operations. We have met with representatives of the PBMs and they have agreed to continue to meet with us to discuss these elements of our bill and to make a ?good faith? effort to arrive at compromise language that will help to address some of our basic elements and concerns that directly impact pharmacy.
Items such as these will be discussed and hopefully be passed in the fall veto session:
We are of the opinion that even though we were not as successful as we had hoped, there is still a great deal of benefit and opportunity for pharmacy under these elements of regulation. We will continue to meet over the summer months to craft language that will be acceptable to regulators, legislators, PBMs, but most importantly that will be beneficial to pharmacy. Thanks to all of you who have called and contacted your legislators on behalf of this legislation. We have not failed to improve the market climate for pharmacy, but rather have created on opportunity to continue working on legislative expansion of this bill into the future. DMEPOS Medicare Information for Pharmacists Please see the information below concerning both the first and second round of DMEPOS competitive bidding. This is important to note because all of you will most likely have a city affected by the second round of the competitive bid program. Additional information may be found on the DMEPOS website at http://www.cms.hhs.gov/DMEPOSCompetitiveBid/01_overview.asp. Medicare Announces Winning Suppliers for the First Round of Competitive Bidding... CMS has released the names of the 325 suppliers that have signed contracts with Medicare to provide certain medical equipment and supplies to beneficiaries in 10 communities across the U.S. at significantly lower prices than they are paying now. The new competitive bidding program goes into effect on July 1, 2008, in 10 communities. This program uses the local, competitive marketplace to lower the costs for certain durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) for Medicare beneficiaries who use Medicare-contracted suppliers to obtain medical items and supplies. Because beneficiaries pay 20 percent coinsurance on the cost of DMEPOS, they will directly benefit from the savings. You can find a list of Medicare contract suppliers in the 10 initial areas of the program by visiting www.medicare.gov (under ?Search Tools? select ?Find Suppliers of Medical Equipment in Your Area) or by calling 1-800-MEDICARE. People can also visit the local offices of the various partner groups, such as their State Health Insurance and Assistance Program, Area Office on Aging and a number of community organizations that can provide information on the program. ...And Extends the Deadline for Suppliers to Become Accredited for the Second Round CMS also announced that it is extending the deadline for suppliers in the 70 second round metropolitan statistical areas (MSAs) to become accredited. CMS is extending the deadline because a significant number of suppliers in those communities have not yet applied for accreditation. Please see the Press Release, Fact Sheet and DMEPOS Competitive Bidding websites for more information.
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