Pharmacy Accreditation Extension

With the enactment of Section 3109 of the Patient Protection and Affordable Care Act (PPACA) on March 23, 2010, all pharmacies, unless they qualify for an exemption, must be accredited for the products and services listed on their Medicare enrollment application (CMS-855S) no later than January 1, 2011.

Pharmacies subject to accreditation should begin the accreditation process as soon as possible, as it could take up to nine months to complete the accreditation process.

A pharmacy that submitted a 'step down' application in response to the February 12, 2010, National Provider Enrollment (NPE West) letter to only provide non-accredited products as shown in section 2C of their amended CMS-855S may continue to bill all supplies and services shown on their previously accepted CMS-855S.

A pharmacy that submitted a request to 'step down' and provide only non-accredited products as shown in section 2C of their amended CMS-855S prior to the February 12, 2010, NPE West letter must submit CMS-855S listing all products and services they will supply. 

Note: The authorized or delegated official must sign and date the CMS-855S.

Any pharmacy that voluntarily terminated its enrollment in the Medicare program must complete and submit a new Medicare enrollment application (i.e., CMS-855S) to reenroll in the Medicare program. These applicants are considered new enrollees. In addition, pharmacies must meet the supplier standards found at 42 CFR 424.57, except for the accreditation requirements found in 42 CFR 424.57(c)(22) through 42 CFR 424.57(c)(26).