WJTV News Channel 12 - Legislation Would Allow Pharmacies to Directly Bill Medicare

Legislation Would Allow Pharmacies to Directly Bill Medicare

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Washington D.C. -

U.S. Senators Thad Cochran and Roger Wicker (R-Miss.) today announced the introduction of legislation that would stop a new federal regulation that will make it more difficult for senior patients in Mississippi and other states to receive certain pain medications.

 

Cochran and Wicker have introduced legislation (S.914) to again allow pharmacies to bill Medicare Part B directly for drugs prescribed by doctors and used in implantable intrathecal pain pumps.  The measure would restore a billing procedure used by pharmacies in Mississippi and other states for more than two decades to ensure access to these specialized medications.

 

The Centers for Medicare and Medicaid Services (CMS) in January began barring pharmacies from directly billing Medicare for these services, instead choosing to only accept reimbursement bills from physicians who purchase the compounded drugs from pharmacies.

 

"With this final rule, the Centers for Medicare and Medicaid Services has not fully taken into account patient impact or state regulations. During the public comment period, pharmacies, physicians, and patients overwhelmingly opposed this billing change," Cochran said.  "There was no compelling reason to move forward with the rule.  Seniors with chronic pain disorders are already experiencing reduced access to their medications because of this new regulation, which flies in the face of Mississippi's prohibition on pharmacies selling compounded pain medications to physicians."

 

"Countless Mississippians depend on medications provided by local pharmacists, and CMS's proposed action threatens to end patients' access to this care," Wicker said. "CMS should completely rescind this erroneous interpretation of a successful policy that has been in place for decades. This legislation will fix the problematic ruling by CMS and preserve patients' access to critical medications while ensuring that safety and quality measures are met."

 

Under pressure from the entire Mississippi congressional delegation and others, CMS went through full comment and rulemaking procedures, rather than forward with the clarification that was originally proposed in 2011.  Only 2 percent of the public comments received from pharmacies, physicians, patients, state pharmacy boards, and elected officials from 26 states supported the change.  Some commented that the rule would impede seniors' access to care and place a financial burden on physicians who might be unable to afford purchasing and rebilling these medicines to Medicare.

 

The rule also raised safety issues associated with compounded medicines.  Pharmacies that directly bill Medicare must comply with federal accreditation rules that include compliance with requirements for sterile compounding and handling of these compounded medicines.

 

The Cochran-Wicker legislation, which would not affect the amount billed for these drugs, has been referred to the Senate Finance Committee.  Representative Gregg Harper (R-Miss.) introduced a companion measure (HR.232), which is cosponsored by Representatives Bennie Thompson (D-Miss.) and Steven Palazzo (R-Miss.).

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