January 2022 - Newsletter

Included in this newsletter


OSHA Mandate on COVID-19 Vaccines

The U.S. Supreme Court issued a mixed ruling on Thursday, January 13, 2022, on the two COVID-19 mandate cases. The OSHA mandate on the vaccine-or-testing requirement for private businesses with at least 100 employees has been struck down as unconstitutional. However, the court is permitting the CMS Healthcare regulation to remain in place. There has been a lot of information about who this applies rule applies.

As for RJ Hedges & Associates clients only, the federal register list of providers/suppliers only applies to Home Infusion Therapy (HIT) Suppliers, including their administrative staff. Retail pharmacies, LTC pharmacies, DMEPOS suppliers are not mentioned in the Federal Register as applicable

suppliers. Pharmacies within hospital pharmacies open to the public will have to follow their parent organizations' requirements. However, Emergency Temporary Standard (ETS) is linked to any entity that receives federal funding for suppliers, which may be defined as suppliers providing COVID-19 vaccines and COVID-19 testing. If this is true, this requirement will bring many pharmacies into this requirement. DMEPOS facilities do not fall into any of the requirements. Federal Register

Link Accreditation Organizations have the primary enforcement arm of this regulation. Additional information can be found at Click Here

We will shortly have policies and procedures, forms, and plans upon the Compliance

Portal. Enforcement is not starting; however, Accreditation Organizations are already changing their standards as part of their accreditation surveys. More information is coming and will be sent out in Bulletin format.


Justice Department Files Complaint Against Professional Compounding Centers of America Inc. for Reporting Fraudulent Pricing Information for Ingredients Sold to Pharmacies

The Justice Department has filed a complaint under the False Claims Act against Professional Compounding Centers of America Inc. (PCCA), a Houston-based company that sells active pharmaceutical ingredients and other products and services to compounding pharmacies. The complaint alleges that PCCA reported fraudulent and inflated Average Wholesale Prices (AWPs) for its ingredients that bore no relationship to the actual prices at which it sold those ingredients to its pharmacy customers, thereby causing those pharmacies to submit inflated compound prescription claims to TRICARE, the federal health care program providing insurance for active duty military personnel, military retirees and military dependents. Read More.


Rocky Start to the OTC Test Program

Late last week, NCPA was still trying to get answers for members on how the OTC COVID-19 test program announced earlier in the week would work. What we know is that while it

is technically possible to submit a claim to a PBM for an OTC COVID-19 test, neither party was ready for the transactions when the program started on Jan. 15. NCPA and other pharmacy organizations drove home the point that the administrative burden of this approach is untenable and other solutions that allow patient to get COVID-19 tests with no up-front cost must be put in place. Pharmacies that choose to submit claims should refer to this handout that summarizes the guidance from NCPDP on submitting a claim for an OTC product that does not require a prescription. To help provide additional clarity, we have drafted FAQs for our members. We will continue to keep you posted as we learn more.


Pharmacist’s Role to Expand Over Decade Amid the Pandemic and Provider Shortages

Newswise — January 12, 2020-- New research released today by Columbia University Mailman School of Public Health and Express Scripts® Pharmacy, an Evernorth company, reveals that amid growing provider shortages, pharmacists in the U.S. are well-trusted by patients and projected to play an increasingly integral role in care management.

The Prescription of Trust report, which surveyed more than 3,000 patients, 1,000 pharmacists, and 500 providers (including physicians and nurse practitioners), was designed to more deeply understand the expanding role of pharmacists in transforming patient care. It is the largest study of its kind ever conducted and is the first to include the voice of patients.

“The results of the report are clear. Most people trust pharmacists to play a greater role in providing their care. As the shortage of doctors and nurses persists, and as complex new therapies and digital health care technology solutions are developed, the role of the pharmacist will continue to evolve,” said John McHugh, MBA, PhD, an assistant professor in the Department of Health Policy and Management at Columbia University Mailman School of Public Health.


Trainings on the Compliance Portal®

You can’t rush a good thing! We are very excited to announce our new eLearning platform is in final beta testing! This means in the upcoming months we will be able to start providing monitoring, tracking, reporting, and record keeping for Compliance Trainings on our Compliance Portal®. Many of our trainings will be getting updated to fully utilize all the features in this new section. We are planning a rolling launch and will be adding new trainings monthly in conjunction with our Monthly Task List training requirements. By the end of 2022, all trainings will be migrated to this new platform, and we hope to offer additional trainings to help you and your staff maximize your knowledge on compliance and achieve completion with all training requirements. Stay Tuned for more details, in the meantime enjoy this preview photos.


R.J. Hedges Bulletin Releases/Webinars

(found in the Message Center)

The following items can be accessed through the Message Center on the Compliance Portal®: