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»  Posts By   June 2012 

OIG Report on Test Strips and Lancets Forecasts Increased Auditing of Pharmacy/DME Suppliers

On June 13, 2012, the OIG issued a report following its review of 4 contractors that processed claims for test strips and/or lancets. The report concludes that the Medicare contractors improperly allowed for payment of a total of approximately $271 million in claims that the OIG identified as high utilization claims. The OIG estimated that the contractors improperly paid $209 million to pharmacies/DME suppliers.  This is a summary of the...

With Regulatory Enforcement of HIPAA on the Rise and Increased Penalties for Non-Compliance, Pharmacies Must Take Action

The United States Department of Health and Human Services Office for Civil Rights (OCR) has stepped up enforcement of the compliance requirements contained in the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and has begun sending out HIPAA Audit Letters to Covered Entities. So far, twenty HIPAA Audit Letters have been sent out to a variety of Covered Entities, including physicians, laboratories, and pharmacies. The OCR intends to...

OIG Advisory Opinion Related to Patient Copayment

The OIG recently issued an Advisory Opinion Letter to an anonymous pharmacy that relates to a hot-topic Pharmacy Law Issue—Copayment Assistance. The OIG advised that it would not take any action against the pharmacy for a “proposed arrangement” involving a rewards program under which patients would receive gasoline cards for amounts spent at the pharmacies, including copayments for Federally covered medications. This Advisory Opinion could provide an avenue for pharmacies to create...