The healthcare reform bill recently passed by the U.S. House eliminates a proposed surety bonding requirement for pharmacies that sell durable medical equipment, an absence that has raised the ire of insurers nationwide.
“In the absence of bonding, who will be looking to assure that all providers that submit claims to Medicare are legitimate and that overpayments, fines and penalties assessed by CMS (Centers for Medicare and Medicaid Services) are paid?” Lynn M. Schubert, president of the Surety & Fidelity Association of America, told National Underwriters News Service.
Earlier this fall, community pharmacies received a brief reprieve after President Obama signed into
law a bill extending new accreditation requirements set to begin Sept. 30.
Part of a rule imposed in January by the Centers for Medicare & Medicaid, the new accreditation process required DME suppliers to obtain a $50,000 surety bond for each business outlet, among a host of other mandates.
The new CMS regulations included exemptions for several groups, but both nursing homes and pharmacies were not among them. Pharmacy groups had argued for months that the new requirements for sellers of durable medical equipment and diabetic supplies shouldn’t apply to the industry.
About half of the nation’s 113,000 durable medical equipment providers are pharmacies, according to CMS estimates.
The controversy is likely to linger. Despite the House bill’s lack of a mandate, the U.S. Senate’s proposed healthcare bill does include a DMEPOS bonding requirement for pharmacies. Ultimately, Senate Democrats will likely have the final say on whether pharmacies keep the exemption.