NCPA urges delay of PECOS changes that could deter community pharmacy industry
ALEXANDRIA, Va. Fearing that the implementation of an electronic provider enrollment program for Medicare Part B in its current form by the Centers for Medicare and Medicaid Services could disrupt Part B beneficiaries’ ability to obtain access to their services and supplies, the National Community Pharmacists Association is hoping that the CMS will delay its implementation and make other changes.
The provider enrollment, chain and ownership system is an online system that Part B providers can use instead of paper enrollment so that they can sell durable medical equipment, prosthetics, orthotics and supplies, also known as DMEPOS.
The CMS originally had planned to roll out PECOS on Tuesday, but it announced June 30 that while the original implementation date would still be effective, it would “not implement changes that would automatically reject claims based on orders, certifications, and referrals made by providers that have not yet had their applications approved by July 6, 2010.” The NCPA had asked the CMS to delay implementation until Jan. 3, 2011.
Other recommendations made by the NCPA included requiring pharmacy access to nightly provider-referrer enrollment updates to PECOS and removing requirements to include the teaching physician as the ordering or referring supplier and the legal name of the physician or eligible provider on the claim.
“Community pharmacies appreciate and support the PECOS program’s effort to reduce waste, fraud and abuse in Medicare,” NCPA acting EVP and CEO Douglas Hoey said. “However, the slow pace of enrollment and database updates, along with other deficiencies, creates headaches for community pharmacies and could limit access to Medicare Part B medical supplies for seniors, especially in underserved areas.”
CVS Caremark: Generic dispensing rates rise as plan member contributions drop
WOONSOCKET, R.I. CVS Caremark’s annual insights report revealed an increase in generic dispensing rates as plan member contributions declined.
According to the 2010 Insights Report, which provides an annual review of drug trend performance for the company’s PBM client segments, 2009 drug trends show that CVS Caremark clients were able to manage pharmacy costs in the midst of the economic recession without passing along added costs to their members. In addition, plan sponsors increased their overall use of generics. These factors helped plan sponsors manage their costs while minimizing out-of-pocket costs for their members.
“While each of our client segments had different approaches and leveraged different tools, they all shared a priority in 2009 — finding ways to manage pharmacy costs,” stated Per Lofberg, president of CVS Caremark’s PBM business. “In these challenging economic times we worked with our clients to implement plan designs that would enable them to continue to control pharmacy costs while still providing their members with access to the medications they need, programs to support medication adherence and opportunities for out-of-pocket savings.”
Plan sponsors made few changes to member contributions levels last year and member contributions actually declined from 19% in 2008 to 15.7% in 2009. In addition, plan sponsors embraced opportunities to educate their members about the benefits of generic medications and encourage their use. This resulted in the CVS Caremark Book of Business generic dispensing rate increasing to 68.2% from 65.1% in 2008, despite a lack of significant generic drug introductions in 2009.
Sandoz launches generic Exelon
PRINCETON, N.J. Sandoz has launched a version of a drug for treating dementia, the generics arm of Swiss drug maker Novartis said.
Sandoz announced the launch of rivastigmine tartrate capsules in the 1.5 mg, 2 mg, 3 mg, 4.5 mg and 6-mg strengths. The drug is used to treat mild to moderate dementia associated with Alzheimer’s and Parksinson’s diseases.
The drug is an authorized generic version of Novartis’ Exelon, which had sales of $132.7 million during the 12-month period ended in March, according to IMS Health.