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IL license lawyerThe world of healthcare is constantly changing. For some pharmacies, keeping up with these changes can be difficult, particularly for independent or small pharmacies. The Centers for Medicare and Medicaid Services (CMS) is the governing body that oversees the practices of different medical professionals who provide services covered by Medicare and Medicaid. One of the goals of CMS is to try to cut down on healthcare fraud and they do this by conducting audits to ensure providers operate within the legal standards. CMS audits can sometimes produce less-than-favorable results that could seriously affect the operation of your pharmacy and its financial wellbeing. Here are a few things you and your employees can do to minimize any errors or inadvertent fraudulent practices:

  • Ensure you are meeting requirements for both non-controlled and controlled substances. When filling and dispensing a prescription, there are certain pieces of information that you must collect, plus a few special pieces of information for controlled substances. To fill a prescription, you must have the prescriber’s signature on the prescription, the name, strength and dosage form of the drug, the directions for use and the number of pre-authorized refills (if any). For controlled substances, the prescriber must have the appropriate authority to prescribe such a drug and the prescriber must manually sign the prescription on the date it was issued.
  • Follow proper procedures for prescription dosages that exceed the Food and Drug Administration (FDA) guidelines. If you or your employees notice that a drug has been prescribed an unusually high dosage or in a dosage that exceeds the FDA’s recommendations, you should first check the drug’s dosage guidelines on one of the online references. If the dosage does, in fact, exceed FDA guidelines, you should contact the prescriber to verify the dosage amount. Be sure to get a hard copy of all communication regarding dosage and include the patient’s diagnosis and the prescriber’s reason for overriding the dosage guidelines.
  • Ensure your employees properly document when a beneficiary receives his or her prescription. This is one of the rules that exists to ensure the chain of possession is accurate. When you fill a prescription for someone, you must document that they received their prescription. Maintaining an accurate signature log can help you avoid accusations of fraud.

An Illinois Medicare Pharmacy Audit Defense Lawyer Can Help

Before you are subject to a field audit, CMS will notify you of the date, giving you time to prepare and ensure things are in good working order. A CMS audit can be extremely important -- consequences of a negative audit can range from a simple warning or monetary fine to forfeited CMS reimbursements. At the Law Offices of Joseph J. Bogdan, LLC, we can help you prepare for an upcoming CMS audit or we can help you challenge the results of an already completed audit. Get in touch with our knowledgeable Illinois Medicare pharmacy audit defense attorneys today to begin talking about your case. Call our office at 630-310-1267 to schedule a free consultation.

 

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IL license defense lawyerIf you are a healthcare provider that prescribes controlled substances, you are being monitored by the Drug Enforcement Administration (DEA). Due to the potential for illegal activity in the pharmacy business, DEA inspectors visit pharmacies to ensure that they are complying with all regulatory standards. If the DEA pays a visit to your pharmacy, it is important to react in a calm and professional manner. Still, a DEA investigation can lead to harsh punishments and even license revocation. If you are facing a DEA investigation, contact a license defense attorney that you can believe in.

Preparing for a DEA Visit

Due to the implementation of the Controlled Substances Act, the DEA is allowed to inspect a pharmacy, investigate the receiving and distribution of controlled substances, and even take substance samples. How you react to a DEA visit can make all the difference in ensuring that the investigation goes smoothly.

Be Respectful: When the DEA arrives at your pharmacy, for an inspection, it is easy to feel attacked, and become flustered. As the inspectors arrive, being kind and respectful can set the investigation off on the right foot. All that considered, it is also important to understand your rights. A DEA inspection can only take place with your consent. If the inspection is not being conducted during standard business hours, or there is not proper personnel on site, you can request for the inspection to take place at a different time.

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Illinois DEA registration defense lawyer 104 formIn light of the current opioid epidemic in the United States, state and federal governments – as well as state boards of pharmacy and medicine – have ramped up their investigations into suspected improper prescribing habits. In particular, the Drug Enforcement Administration (DEA) is aggressively reviewing prescription and medical records for pharmacists and physicians who hold DEA registrations.

Increasingly, these DEA registrants are reporting that DEA agents are appearing unannounced at their homes or businesses to interview the registrants and inspect the premises for evidence of wrongdoing. In most cases, the agents then ask the registrants to sign what’s called a 104 Form, whereby the registrant voluntarily surrenders his or her DEA registration. The agents assure the registrant that the surrender is temporary and that he/she can get his/her registration back “in a few weeks” as long as they cooperate with the investigation.

You should not do this without first consulting an attorney.

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Illinois license attorneyWorking toward the pharmacy license takes much time and effort. For domestic applicants, meaning those who have obtained education for the pharmacy license in the United States, the requirements are different from those who have obtained education for the pharmacy license internationally. There are tests that international applicants may have to take to determine their status of qualification for the pharmacy license.

The Application Process for International Applicants

Pharmacy license applicants who have graduated from a professional degree program from outside the United States or its territories should submit proof of a Foreign Pharmacy Graduate Examination Committee Certificate, or FPGEC. Also, the applicant needs to successfully pass the preliminary diagnostic examination, called the Foreign Pharmacy Graduate Equivalency Program, which determines the equivalence of education to approved programs.

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Posted on in Pharmacy License Defense

Illinois license lawyerThe process to become a licensed pharmacist takes much time and effort, and to own a pharmacy comes with more expectations and requirements. If you own a pharmacy, you may expect to have pharmacy compliance audits run from time to time. There are many factors in pharmacy audits that you need to know in order to meet guidelines to keep the pharmacy intact.

Definition of Pharmacy Audit

A pharmacy audit is a formal review of operations and processes to make sure that pharmacies are compliant with pharmacy regulations and other related agreements. The pharmacy audit process can come in many different types, including desktop, onsite, prepay claims review, and investigational pharmacy audits.

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