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by: Theresa Flaherty - Friday, October 30, 2009

candy-cornWell, once again it's Halloween and I am trying to decide whether to give out candy (good candy, like Reese's or M&Ms as opposed to say, Bit o' Honey). Maybe a less, shall we say, sugar-chocked item would suffice?
It's not just because, as a person with Type 1 diabetes, I rarely eat the stuff any more and prefer to avoid the temptation (and calories). It's also because I see your kids out there and, well, they don't look like they need it. They're getting bigger everyday. And, before you parents of "husky" kids scream defensively "He's just big-boned!" let me just assure you, it's your fat kid that always gets greedy, groveling and grasping for two or three candy bars (Get those pudgy fingers away from me).
Coincidence? Not!
Do I sound like the Wicked Witch? Believe me, it's not the first time comparisons have been made.
But let's face it: People who don't take care of themselves wind up costing the health care system money. Lots of it. The younger they start, the more they cost. The fatter they are, the more they cost. The greater the co-morbidities, the more they cost. This is where I would normally insert rising rates of obesity and type 2 diabetes, but we've all see the statistics.

With all the focus on health care reform, the topic of personal responsibility comes up again and again, and rightly so.
Taken all together, stickers and pretzels are starting to look like a better alternative all of a sudden.

Theresa Flaherty

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by: Theresa Flaherty - Thursday, October 29, 2009

[Posted 10/27/2009] Qualitest Pharmaceuticals and FDA notified healthcare professionals of a nationwide recall of Accusure Insulin Syringes. All syringes, regardless of lot number, are subject to this recall. These syringes were distributed between January 2002 and October 2009 to wholesale and retail pharmacies nationwide (including Puerto Rico). The syringes in these lots may have needles which detach from the syringe. If the needle becomes detached from the syringe during use, it can become stuck in the insulin vial, push back into to the syringe, or remain in the skin after injection. Consumers who have any Accusure insulin syringes should stop using them and contact Qualitest at 1-800-444-4011 for reimbursement.

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by: Theresa Flaherty - Wednesday, October 28, 2009

Add prison inmates to the growing list of niche populations for sleep apnea.

Executive director Ed Grandi, executive director of the American Sleep Apnea Association, gave a talk at a conference attended by health care providers who work with incarcerated adults and adolescents.

In his talk, Grandi offered basic information on how to address this problem as well as suggestions on how to improve adherence to therapy.

I just wonder what kind of problems creep up in tiny prison cells when one inmate suffers from sleep apnea. Which is worse for his cellmate? The snoring?  A noisy CPAP machine? Can they even use CPAPs in prison?

Theresa Flaherty

by: Theresa Flaherty - Friday, October 23, 2009

A provider emailed me the other day wondering if the deadline extension for pharmacies to get accredited would include big-box stores like Walgreens.

I couldn't provide him with a detailed answer, except to say I didn't think so (hey, this stuff confuses me, too).

I do know that part of the reason for the extension was also to buy more time to get a permanent exemption from the requirement in there.

This morning, in poring over VGM's analysis on the latest version of the Senate Finance Committee's health care bill (thank you VGM!)  I came across the provision to permanently exempt "certain" pharmacies from accreditation. Here it is:

Effective January 1, 2010, the Committee Bill would make certain pharmacies eligible for an exemption from the accreditation requirements.  A pharmacy would be exempt from the accreditation requirements under the following circumstances: (1) the pharmacy submits an attestation that its total Medicare DMEPOS billings are, and continue to be, less than a rolling three year average of five percent of total pharmacy sales; (2) the pharmacy submits an attestation that it is enrolled as a provider of durable medical equipment, prosthetics, orthotics, and supplies under the Medicare program for at least 5 years and has had no adverse determination against it for the last five years due to fraud; and (3) the pharmacy is willing to submit documentation to the Secretary (based on a random sample of pharmacies) that would allow the Secretary to verify the information in (1) and (2).  The documentation submitted for (3) would be required to consist of an accountant certification or filing of tax returns by the pharmacy.

The provision would also allow the Secretary to determine accreditation standards that are more appropriate for pharmacies. The Secretary would have the authority to implement this amendment by program instruction or otherwise.

Theresa Flaherty

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by: Theresa Flaherty - Thursday, October 22, 2009

images-11Provider Vicki Jones is tickled pink. She opened a branch of the Women's Health Boutique in Dallas yesterday.

"Channel 11 covered our ribbon cutting," she said. "A full minute! Wow! That was fabulous for us."

It doesn't hurt that it's National Breast Cancer Awareness month, when fall colors everywhere mingle with ubiquitous pink ribbon products.

"We wanted to play off that. The media seems more open to the stories we have to tell during October," said Jones.

Jones has been doing this for 20 years and welcomes the attention breast cancer gets these days. It wasn't always like that.

"Back then, you didn't even say the word breast cancer, no one even knew what the word mastectomy was or how to say prosthesis," she said. "Now, we have NFL football teams wearing pink ribbons during games. That's wonderful."

Theresa Flaherty

by: Theresa Flaherty - Wednesday, October 21, 2009

Undercover police in Phoenix this week busted up a diabetes test strip ring.

Yup, you read that right.
Samuel Camerano, 49, is charged with trafficking in stolen goods. He allegedly buys stolen test strips and resells them on sites such as ebay and to other distributors who then sell them back to the pharmacy.
According to an article on KPHO.com, police said that during the operation Camerano bought 30 boxes of test strips with a value of $2,254 for only $215 on five different occasions believing them to be stolen property. Authorities said the final sale of test strips to Camerano was on Oct. 8, and he was arrested and charged with trafficking stolen property immediately following the transaction.
Police launched their investigation when area Target stores reported an increase in test strip thievery.
In Sarasota, Fla. sheriff's deputies arrested to people, also for stealing test strips—and, randomly, cologne—from two area Target stores.
Personally, I wonder what Target is thinking? I can't even buy store brand glucose tabs without getting a pharmacy staffer to unlock the case for me (and if you've followed my CVS saga, you know how I love to interact with them).

But I digress. Once again, I must ask, why, oh why, do test strips cost so much?

Theresa Flaherty

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by: Theresa Flaherty - Tuesday, October 20, 2009

A bill making the rounds in Ohio would exempt prosthetics from the DME category and make private insurance companies provide the same coverage for limbs as Medicare and Medicaid.

Rep. Denise Driehaus, D, introduced HB 310 last week.

At least 15 states have passed similar bills in the past few years. It's a good idea to pay for limbs. Without them, people are unable to work. That means, in addition to quality of life issues, they typically cost states money to care for them, through increased need for services.

Theresa Flaherty

by: Theresa Flaherty - Thursday, October 15, 2009

President Obama signed HR 3663 into law. Pharmacies have another 3 months to complete the accreditation process.

NCPA executive VP and CEO Bruce Roberts said the association continues to work toward a permanent exemption as well:

“With the signing of H.R. 3663 into law by President Obama, Congress now has a three-month window to add pharmacists to all the other health care providers exempt from the time-consuming, costly, and redundant Medicare Part B DME accreditation requirement.  Both the House and Senate have included pharmacy exemption provisions in the health care reform proposals working their way through Congress. When this permanent solution is added to this temporary solution of a delay, seniors will be the ones who truly benefit. They will be able to continuing getting these critical medical supplies, like diabetes testing strips, from their local pharmacy where many of their health care needs are being met. Without additional action, thousands of independent community pharmacies will be forced out of the program.”

Theresa Flaherty

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by: Theresa Flaherty - Wednesday, October 14, 2009

I spoke with a pharmacy provider this afternoon who is awaiting his accreditation survey. For him, the recent deadline extension for pharmacies is a welcome relief.

For Joe  the HME provider, however, that extension may not seem fair. Maybe it is, maybe it isn't; I can see both sides of the equation: it's what keeps HME News fair and balanced.

Pharmacist John Keegan, who received his accreditation in June, sympathizes, but says it's like comparing apples to oranges.

"We're licensed by our states, we're inspected at least once a year," he said. "That's not to slight DMEs. I don’t believe they understand the nature of our profession—the practices we're built on and the nature of those practices. If the pharmacy is being inspected regularly, its hard to say it’s a fraudulent operation."

As to the extension for his fellow pharms? Eh. Keegan's pleased as punch to have his accreditation wrapped up.

"I don't think they are going to escape accreditation completely," he said.

Theresa Flaherty

Theresa Flaherty

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by: Theresa Flaherty - Tuesday, October 13, 2009

By now you have heard that pharmacies have until Dec. 31 to get accredited. The NSC has posted a few tidbits of information to try and clear up some of the unsurprising confusion:

• DMEs with pharmacists on staff DO NOT qualify for the extension.

• Pharmacies that were not accredited prior to the October deadline are not subject to the revocation of
Medicare billing privileges at this time.
• Any pharmacies that submitted a voluntary termination that now wish to withdraw this request, must submit a letter to the NSC signed by the authorized official.

• The letter MUST be received by the NSC no later than October 23, 2009.

• Letters may be faxed to the NSC by geographic location.

Fax Numbers
East Team - 803-382-2405
Central Team - 803-382-2408
West Team - 803-382-2406

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