With changes brought about by the CMS Final Rule and the impending changes being introduced with the new CMS case-mix classification model, the Patient-Driven Payment Model (PDPM), set to go into effect October 1, 2019, the role of the consultant clinical pharmacist in the LTC setting is becoming even more critical in optimizing patient outcomes, ensuring regulatory compliance, and obtaining reimbursement.
While an extension has been placed around the enforcement remedies for certain Phase 2 Mega Rule and Antibiotic Stewardship requirements from CMS [Nov 2019], it is still necessary to be working towards compliance on these items.
Phase 2 of the Reform of Requirements for LTC Facilities outlines requirements that facilities must meet in order to participate in the Medicare and Medicaid programs as of November 28, 2017. These requirements are aimed at improving the quality of health care and patient safety. Here are the three areas you need to be working towards as a pharmacy servicing Medicare/Medicaid facilities.