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Understand pharmacy accreditation criteria.
Author: Mary Nicholas
Date: August 5, 2010
In July, CMS made information available about the Affordable Care Act, which amends
the Medicare Improvements for Patients and Providers Act of 2008, regarding the
extension of the deadline for pharmacy accreditation until January 1, 2011. In addition
to this extension, pharmacies that furnish DMEPOS may qualify for an exemption if the
pharmacy meets the following criteria:
- The total billings by the pharmacy for DMEPOS are less than 5% of total pharmacy
sales for the previous three calendar years; and
- The pharmacy has been enrolled as a supplier of DME equipment, prosthetics, orthotics
and supplies and has been issued a provider number for at least five years; and
- No final adverse action has been imposed on the pharmacy in the past five years; and
- The pharmacy submits an attestation, in the manner and at the timeframe to be
determined, that the pharmacy meets the criteria listed in 1 through 3; and
- The pharmacy agrees to submit materials as requested during the course of an audit
conducted on a random sample of pharmacies selected annually.
- Total DMEPOS billings are considered as less than 5% of the total pharmacy revenue.
- Newly opened locations are required to be accredited. They do not meet the exemption
requirement of having been enrolled for at least 5 years.
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