NCPA submitted comments to CMS on the proposed physician fee schedule for 2027. NCPA argued that CMS’ proposed rule puts the ability of some pharmacists to provide remote patient monitoring and remote therapeutic monitoring in jeopardy, which would undermine the spirit of the Rural Health Transformation program and deny rural Medicare beneficiaries access to these services. NCPA therefore asked that CMS allow pharmacy PTANs to claim reimbursement for setup/education for RTM and RPM, and to explicitly allow pharmacists to work under the general supervision of physicians to report RPM codes until pharmacists have Medicare provider status. NCPA asked CMS to formally recognize pharmacists as providers eligible to furnish RPM and RTM services both in their scope of practice and in claim reimbursement under Medicare Part B, and asked CMS to instead allow pharmacists to be reimbursed for RPM/RTM through a co-management fee.
NCPA also reiterated its concerns regarding inappropriate rejections of MFP refund claims due to 340B status and the subsequent denial of good faith inquiries by pharmacies that have no contract pharmacy relationships or have a reasonable belief that a claim is not 340B-eligible, asking CMS for a permanent solution.
Read our comments here.
