Does Your Pharmacy Need a “Check-Up?”

Pharmacies are an integral component of the healthcare system. Pharmacies aid in the dispensement and education of mediations and drugs to millions of Americans every year. Due to their handling of potentially dangerous and toxic substances, pharmacies are heavily regulated by both state and federal laws. Due to these numerous regulations, pharmacies often find themselves entrenched in audits or investigations surrounding their operational practices. Just as individuals benefit from their yearly check-ups with their doctor to ensure optimal health, pharmacies can benefit from a so called “check-up” as well. Of course, a pharmacy does not need to be evaluated by a doctor, but a pharmacy should consult with outside experts to ensure all aspects of its business and legal operations are running effectively and compliantly.

Storage of Medications and Other Substances

Pharmacies are allowed to store hazardous drugs, controlled substances, and other drugs for medical purposes. The storage of these drugs is regulated by respective state boards of pharmacy and overarching federal laws. When it comes to Pharmacy compliance, establishments must adhere to proper storage protocols or risk potential fines and other consequences. Regulations surrounding these storage protocols can change and all pharmacies must be aware of any changes and effectively implement these changes. Outside professionals can ensure your pharmacy is compliant with all state and federal guidelines and advise your pharmacy on best practices should changes need to be implemented.

Disposal of Medications and Other Substances

Not only are pharmacies required to properly store drugs, but they are also required to properly dispose of drugs as well. Again, state and federal guidelines dictate how pharmacies are to dispose of drugs and non-compliance with disposal methodologies risks a payout of fines.

Pharmacy Billing Practices

Effective billing is the driving force of a successful pharmacy – after all, reimbursement received from dispensed prescriptions is how a pharmacy sustains its livelihood. Whether your pharmacy contracts with private or federally funded insurers, compliant billing practices respective to these insurers is critical. Pharmacies need to ensure their internal billing practices are not violating state or federal law. Inaccurate billing is one of the most common reasons pharmacies get audited. Oftentimes, pharmacies are not even aware they are billing non-compliantly – just because a claim was paid does not mean it was accurate or acceptable by state or federal guidelines. Having complaint and efficient billing practices not only staves off audits, but also increases profitability for your pharmacy. Outside professionals who are experienced in pharmacy billing and coding can ensure your pharmacy is legally compliant while promoting best practices in revenue generation.

Data Privacy

Pharmacies keep and store protected health information of the patients they serve. This protected information must remain private and pharmacies, like all healthcare operations, must certify internal safeguards are met. Pharmacies must have up to date software regarding data storage to ensure the implementation of federally mandated privacy laws. Access to a pharmacy’s internal systems must be monitored to make sure only authorized access is allowed.

Operational Protocols

Although pharmacists do not write prescriptions, they are still required to verify the legitimacy of them. Pharmacists should never simply accept and fill a prescription without doing their due diligence first. Outside professionals can evaluate your pharmacy’s current prescription verification policies and recommend changes to ensure compliance with both state and federal law.

Controlled Substance Inventory

If your pharmacy dispenses controlled substances, there are state and federal regulations your pharmacy must adhere to each time a controlled substance is dispensed. Pharmacies must ensure accurate record keeping with respect to controlled substances and also must adhere to compliant reporting requirements.

Pharmacy Ownership Structure

Illegal ownership structures involving healthcare entities have been a recent focal point of government investigations. Healthcare entity ownership agreements must be compliant with state and federal laws. Outside professionals can review your pharmacy’s organizational structure to ensure compliance and can advise you in necessary changes need to be made.

Contact Oberheiden, P.C. for Your Pharmacy “Check-Up” Compliance

The experienced pharmacy compliance attorneys of Oberheiden, P.C. can offer help for your pharmacy check-up to make sure you are in compliance with regulations. Contact us today online, or give us a call at 888-680-1745.

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