June 2021 Issue

Business boosting medical at home webinar coming June 29

Medical at Home: A Game-changing Opportunity for Long-Term Care, sponsored by RxSafe, is a high-level overview of the market potential for the service. Join NCPA Long-Term Care Division pharmacists, Ronna Hauser and Bri Morris, and pharmacy owners Ben McNabb and Brian Beach in a discussion around the opportunity, the regulatory landscape, packaging considerations, and the workflow best practices for entering this sector. It's happening June 29 from 2-3 p.m. ET. Reserve your seat today.

Add-on payments for COVID-19 vaccine administration at patients' homes

CMS has announced, effective June 8, 2021, an additional $35 payment for pharmacists and pharmacy technicians administering the COVID-19 vaccine (per dose) in the home of Medicare patients that have difficulty leaving their homes or are hard to reach. This is in addition to the standard administration amount (approximately $40 per dose), for a total payment of approximately $75 for a single-dose vaccine or $150 for both doses of a two-dose vaccine when administered in a Medicare patient's home. CMS will geographically adjust the additional amount and administration rate based on where the vaccine is administered. This is a key announcement for independent pharmacies because it's mostly independents who are visiting homes. Many types of locations can qualify as a Medicare patient's home for the additional in-home payment amount, including a unit in an assisted living facility or group home. However, communal spaces of a multi-unit living arrangement do not qualify as a home for the additional payment amount, nor do Medicare skilled nursing facilities or ALFs participating in the CDC's Pharmacy Partnership for Long-Term Care Program when their residents are vaccinated through this program. Additional information regarding eligibility and restrictions can be found here.

Today is reporting deadline for new CMS nursing home requirements

Last month, you may recall that the NCPA LTC Division reached out to you about upcoming requirements of nursing homes and intermediate care facilities for individuals with intellectual disabilities (ICFs-IID) around the COVID-19 vaccine — educating staff and residents on the risks and benefits, offering the vaccine to all staff and residents, and reporting vaccination status to the CDC. Please note that the reporting requirement applies only to nursing homes but not ICFs-IID, although the latter are encouraged to voluntarily report COVID-19 cases. These requirements went into effect on May 24, and beginning today, Monday, June 14, nursing homes that do not report the required information weekly to the CDC will receive a $1,000 penalty that increases with noncompliance.

If you have not already done so, the NCPA LTC Division suggests reaching out to the nursing homes you work with to see how your pharmacy might be able to alleviate some of their challenges. In order to help you help them, the NCPA LTC Division has summarized the new requirements and provided tools for you to share directly with your nursing home clients. To access these and other resources, visit NCPA's COVID resource center.

The requirements apply to nursing homes, SNFs, and ICFs-IID. ALFs are NOT impacted by these requirements at this time.

NCPA welcomes new CMS administrator, advocates for medical-at-home services

In a welcome letter to Chiquita Brooks-LaSure, NCPA congratulated the new CMS administrator on her recent appointment and requested a meeting to continue the dialogue begun in December 2020 when NCPA met with Brooks-LaSure and other members of the Health and Human Services transition team. The administrator's office has responded to our meeting request and is working to schedule a time to meet with NCPA to discuss the immediate elimination of retroactive pharmacy DIR fees; 2) the retention of pharmacist patient care authorities and flexibilities provided during the COVID-19 public health emergency; 3) the requirement of detailed Part D reporting requirements on pharmacy performance measures; and 4) the development of Part D plan guidance for medical-at-home pharmacy services.

NCPA provides comments to CMS on Part D reporting requirements

On May 18, 2021, NCPA provided comments to CMS in response to its information collection request in conjunction with the Part D rule issued on Jan. 15, 2021, which requires Part D plans to submit pharmacy performance measures and data related to their application to CMS, starting Jan. 1, 2022. NCPA builds upon this regulatory requirement to encourage CMS to maximize the reporting requirements of the plans/PBMs, provide as much specifics as possible on the measures used in determining DIR fees, and identify potential issues across the variance of measures used by the plans. Additionally, NCPA highlighted the discrepancies with applying the same measures across the entirety of the pharmacy ecosystem – with LTC settings being particularly difficult. NCPA will continue to work with CMS on uniform pharmacy performance measures and to bring transparency and fairness to the metrics plans use to reimburse pharmacies in the Part D program.

Two options for taking the Business of Long-Term Care Workshop

Interested in operating a LTC pharmacy, but don't know where to begin? Our popular The Business of Long-Term Care Workshop is now on-demand. Don't miss out. This is the place to start. You can also catch us on the road for a live, in-person, intensive Business of Long-Term Care Workshop, Oct. 7-8, ahead of the NCPA Convention in Charlotte, N.C.

HHS updates deadline to expend Provider Relief Fund payments

HHS announced revisions to the Provider Relief Fund program, extending the deadline to expend PRF payments for recipients who received payments after June 30, 2020, and issuing revised reporting requirements applicable to providers who received one or more payments exceeding, in the aggregate, $10,000 during a single distribution period. The deadline to expend funds received between July 1 and Dec. 31, 2020 is Dec. 31, 2021, while funds received between Jan. 1 and June 30, 2021 must be expended by June 30, 2022, and funds received from July 1 and Dec. 31, 2021 must be expended by Dec. 31, 2022. Please note that if you received a PRF payment between April 10 and June 30, 2020, the deadline to use those funds remains June 30, 2021. The revised reporting requirements can be found here. The PRF Reporting Portal will open for providers to start submitting information on July 1. More information can be found on the PRF website here.

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