This time of year, children are compiling Christmas wish lists, trying their hardest to stay on Santa’s “Nice List” and possibly doing extra things to move off the “Naughty List.” We’ve had a lot of questions lately about another Naughty List out there, the OIG Exclusion List or List of Excluded Individuals & Entities (LEIE). Most people already know that if a person or entity commits Medicare fraud they will go on the exclusion list, but many pharmacy owners have been wondering, “What else might someone do to get on that list?” We’ve compiled a few ways to stay off the OIG Naughty List, aka the OIG Exclusion List.
Regardless of the ailment, independent pharmacies should always be asking the same question: How can we best serve the market and the patients who are suffering? When it comes to diabetes, there absolutely is a market for products and services. It’s estimated that more than 100 million adults in the United States have diabetes or prediabetes, and that estimate is getting larger by the year.
Diabetes is a chronic and prevalent medical illness that often leads to circulatory problems, stroke, heart disease, kidney disease, and even blindness. Filling prescriptions for diabetes medications is a start, but independent pharmacies should be doing more to serve the diabetes patient market. Pharmacies can provide education and resources to better help patients manage their disease and even protect them from related medical problems. However, independent pharmacies should also consider offering non-prescription diabetes products, like a diabetic shoe program.
A diabetic shoe program, when combined with other ancillary services, can directly impact margins for independent pharmacies. Improving your margins is still a product of the number of prescriptions filled, but aggressively marketing these additional services can attract and secure additional customers. Big box pharmacies typically don’t offer diabetic shoe programs, giving independent pharmacies an edge with this demographic. Expanding your pharmacy’s diabetic care services leads to healthier patients and better margins, so it’s a true win-win situation.
So, how does an independent pharmacy develop a diabetic shoe program? Let’s explore the subject.
Sometimes life isn’t as easy as we hoped it would be. An accident, illness, or injury can happen
Fraud, Waste and Abuse Compliance
For some reason, it seems people think fraud, waste and abuse prevention compliance is difficult. While it is boring and it clearly has some scary ramifications when not followed, it’s actually very simple and fairly easy to implement. In this article, we will discuss why having a FWA prevention compliance program is important, things you can do to get started, examples of other people who thought they didn’t need to have all their FWA items in place and the issues they got into and some solutions to keep you from getting into hot water with Medicare and OIG.
Prior to the 1940s, nearly all prescription medications were compounded. With the increased demand for mass manufacturing of drugs after World War II, the number of compounded medications quickly dwindled. Unfortunately, this led many patients to not have all their needs met. Luckily today, many community pharmacies are able to compound medications to help personalize medications for patients who need alternate strengths, dosage forms, flavors and even alter ingredients because of allergies or sensitivities.
In order to stay competitive, many businesses are turning to offshore companies as a way to cut costs while still providing tech support, customer service, billing processes, and more. Consider your contracted companies with which you have signed a business associate agreement (BAA); could any of them be utilizing offshore workforces?