News You Can Use: Tell the Left Hand About the Right Hand's Drug Transfers

Sketchy interpharmacy swaps spell federal trouble

If your facility maintains multiple pharmacies, you should take special pains to document the transfer of drugs between them, because interpharmacy transfer regulations are no joke.
 
That's the lesson from a recent settlement between Griffin Health Services Corp. in Derby, Conn., and the federal government. According to U.S. Attorney Kevin O'Connor, Griffin will pay a $180,000 civil penalty to resolve claims that it didn't comply with Drug Enforcement Administration documentation rules.
 
The alleged violations involve requirements relating to maintaining, receiving and dispensing records for Schedule II narcotics, forwarding order forms to the DEA, and documenting transfers between pharmacies.
 
Griffin operates two pharmacies, one that serves the inpatient population and another for clinic patients and the public. O'Connor says that there are "stringent" rules about the purchase and sale of controlled substances between two pharmacies operated by the same hospital.
 
Griffin officials say that the requirements are extremely complicated and that the hospital took corrective action as soon as the issue was brought to its attention, according to news reports. The settlement agreement spells out that the hospital denies breaking any laws.

Facilities confused about how much is too much when it comes to charge-based Medicare payments could soon get some guidance from the HHS Office of the Inspector General (OIG).
 
In a Sept. 15 Federal Register notice, the OIG says it's planning to clarify the regulations that govern when it is allowed to exclude a provider from Medicare and other federal healthcare programs for billing for amounts that are substantially in excess of its usual charges.
 
The proposal includes a formula that defines "usual charges" as well as a bright line for "substantially in excess" that's set at 120 percent of usual charges. The watchdog agency invites comments on the proposal, which are due Nov. 14.
 
The exclusion rule would primarily affect providers of Part B services, including clinical laboratory services, durable medical equipment and supplies, and drugs. It could also play into outlier enforcement - a current OIG hot button. So if there's a big difference between what you charge Medicare and what you charge other customers, the OIG could soon show up at your doorstep.
 
To see the rule, go to http://a257.g.akamaitech.net/7/257/2422/14mar20010800/edocket.access.gpo.gov/2003/03-23351.htm.

- Published on 2003-10-06