Pharmacy or DME: The Time is Ripe to Become Both

by admin on August 13, 2018 No comments

pharmacy dmeBy: Michael Silverman

People looking to enter the direct-to-consumer medical supply business often question whether becoming a pharmacy or durable medical equipment provider (DME) is a “better” endeavor.

Now, more than ever, due to industry changes and because of the synergies between the two, the answer is “ become both.”

Think about it.

Most patients require the benefits of both types of providers. By combining the capabilities of a durable medical equipment supplier with that of a pharmacy, and by being licensed/accredited for both, one can essentially provide for a majority of their patients’ at-home medical needs from a single location.

Take a typical piece of durable medical equipment, or “DME” for short, such as a nebulizer, which is covered in part by Medicare Part B or commercial medical supply benefits.

If a standalone DME provider (not a licensed pharmacy) provides a nebulizer to their patient, that piece of equipment is essentially useless until that person receives medication, such as duoneb or albuterol, from a licensed pharmacy provider to put in that nebulizer.

Another example, of a standalone DME supplier providing diabetic testing supplies, such as blood glucose monitors, test strips and lancets that are covered under medical benefits, is only supplying their patients with half of what they need in certain situations. Many diabetic patients require insulin, diabetic maintenance medications, alcohol prep pads and other items that are only covered by pharmacy benefits or can only be dispensed through a pharmacy.

By becoming a one-stop medical supply provider, patient care, satisfaction, and overall well being can be drastically increased.

Furthermore, there are additional benefits of being licensed as pharmacy. In the state of Florida, for example, if a provider holds a pharmacy permit, a Home Medical Equipment license that would otherwise be necessary for certain types of DME is not required (see previous article touched on DME state licensure requirements).

With Medicare’s Competitive Bidding Program being brought to a halt come 2019, at least concerning certain supplies being limited to a select few providers, the time is ripe for change. Patients receiving mail-order diabetic testing supplies, for example, which have been limited to less than two-dozen Medicare bid winning DME suppliers for the past 5 years, will soon have the opportunity to utilize any provider of their choice amongst any Medicare enrolled DMEPOS supplier.

Regardless of operating as a DME, a pharmacy, or both, such provider must comply with a host of laws and regulations, rightly so, and should ensure they are keenly aware of them so they may compliantly provide for proper patient care.

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