[NPInfo] pharmacist and injections

[Dena]

Wikipeida is an encyclopedia so is a reliable source for definitions and
general information. The information on it should not be used for research
or scholarly literature review. But I don't think that's what's being done
here. With your reasoning, anytime ANYONE sells a product or service for
profit, they're guilty of the kickback. Which means that if you're hungry
and go to McDonald's, and they a sell you a hamburger and make a profit,
they're guilty! Or you take your car into the dealership for repair and they
say it needs a $5000 new engine but, since you don't want to do invest a ton
of money into an old car, they turn around and sell you a new car instead
and make a big profit (sorry, it's only been two weeks and I miss my 2000
Mustang convertible terribly-- the pain is still very fresh!!). Is THAT a
Stark law violation?? I didn't HAVE to buy a new car and I certainly didn't
need to buy it from them-- I had a choice.

Hey, D-- where are you when we NEED an attorney??? Please help Margie with
this Stark law and kickback stuff! 
Dena Galler


-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
Of Margienp at aol.com
Sent: Sunday, August 24, 2008 5:03 AM
To: npinfo at nurse.net
Subject: Re: [NPInfo] pharmacist and injections

 
 
JUST fyi Wikepedia is not a source to use.
I know everyone wants to do these to prevent flu , I guess to hell with the

laws.
Sorry this is a violation of the stark law. It self referral , where the  
pharmacists are making a BONUS from the amount of shots they give. 
AGAIN WIKEPEDIA   is not a reputable source. I hope you all are  not using 
that on papers.
In a message dated 8/24/2008 6:10:58 A.M. Eastern Daylight Time,  
sgwiers at hotmail.com writes:

Not to  mention, in reality, influenza vaccines aren't typically a
profitable 
service;  the pharmacy isn't in this for major profit.  In my area, we
pretty 
much  just cover our costs.  We provide them as it is in the best interest
of 
 our patients.  With nearly 40,000 people dying in this country annually
due 
influenza-related complications (perhaps the statistic has changed as I  
haven't looked it up in a couple of years), the bottom line is making sure
as  
many higher risk people have access to the vaccine as possible.   

Sue  



> Date: Sat, 23 Aug 2008 22:42:31  -0400> From: stephanie2u at optonline.net> 
Subject: Re: [NPInfo] pharmacist  and injections> To: npinfo at nurse.net> > I 
don't agree with you about  this. I don't think any anti-kickback > statute
would 
apply to a pharmacy  advertising flu shots administered > by their 
pharmacists. How is this  different from them advertising any > other
service? They 
certainly have a  right to advertise and generate > revenue.> > For one
thing, 
where is  the kickback? A kickback means Doctor A > refers patients to
Doctor B in 
 return for Dr. B kicking back part of > the fee to Dr. A--fee splitting. Or

Dr. B pays Dr. A to refer > patients to Dr. B. It doesn't seem to have any  
relevance to the > pharmacy giving flu shots unless the pharmacy is
promising 
doctors a > share of the revenue from the flu shots in exchange  for sending
> 
patients there.> > I looked up the Stark law. It's  described very briefly
on 
wikipedia:>  http://en.wikipedia.org/wiki/Stark_Law> Now I remember reading 
about it  when it was passed; it was mostly to > address a number of
physician  
practices that also owned labs. The > doctors in the practices were
ordering 
an excessive number of lab > tests because it was generating a lot  of 
revenue for the labs (& then > into their pockets) from Medicare. It  was an
abuse 
of Medicare, and I > don't think it is relevant to this  situation with the
flu 
shots > either. It's more in the category of  Medicare/Medicaid mills and > 
other business arrangements intended to suck  cash out of the Medicare > 
program.> > Stephanie Walker, FNP> >  > > > On Aug 23, 2008, at 10:57 AM, 
Margienp at aol.com wrote:> >  >> >> >> > The pharmacist receives the phone
call and  tells 
the pt to come to the> > pharmacist location of employment.>  > As you
stated 
the pt can go anywhere, but the important aspect is >  > that the> > pt
knows 
that the " referral person" has a financial  interest . The > > refer> > 
should have a sign up that relates  this to the pt.> > I see why our system
of 
health care is failing.>  > If I am to follow your logic then we should not
have 
any laws for >  > monopoly ,> > fraud etc?> > In a message dated 8/23/2008  
9:49:42 A.M. Eastern Daylight Time,> > galdena at sbcglobal.net writes:>  >> > 
Sorry, still don't understand your argument. How is a  pharmacist> >
administering 
an injection guilty of the Stark law? A  medical > > practice will> > bill 
for an injection after the  provider orders it and has the > > medication
on> > 
site, so they  are also profiting. If a patient is ordered an > >
injectable> 
>  medication, SOMEONE has to administer the injection or the > >
medication 
does> > the patient no good. In your argument ONLY a medical  practice > > 
should do this> > and profit from it?> >>  > Many medical practices do their
own 
labs on site for speed and > >  patient> > convenience-- one-stop shopping 
with immediate results in  most > > cases-- but> > patients ALWAYS have the 
option of saying,  "No thanks-- I'd rather > > drive 10> > miles away to get
my 
labs  done elsewhere" and shop around for a > > better rate.> > And
patients can 
shop around for the best prices for their flu > > shots and  go> > to where 
it is most convenient and fastest for them... and, in  > > many cases> > the

pharmacy is faster and cheaper.> >  Dena Galler> >> > -----Original 
Message-----> > From:  npinfo-bounces at nurse.net
[mailto:npinfo-bounces at nurse.net] > > On  
Behalf> > Of Margienp at aol.com> > Sent: Saturday, August 23, 2008  5:43 AM> >

To: npinfo at nurse.net> > Subject: Re: [NPInfo]  pharmacist and injections> >>
>> 
>> > I will attempt  to explain the stark law, if one has a vested, > > 
financial> >  interest in a product such as medications, labs etc one can
not > >  
refer pt to> > have> > the service, and would be a violation .  This would
be 
considered a > > kickback> > as> > you are  receiving profit from you 
referral. The government is mainly> >  concerned about medicare/medicaid
fraud. 
Florida is one of the > >  highest> > states for> > the level of fraud,
concerning 
referrals  for DME's. If I refer to > > myself or> > my> > entity, I  can
bill 
how ever I want.> > As we say in the south "This is like the  rooster
guarding 
the > > henhouse".> > This is a great concern ,  as many drs own labs, and 
radiology > > centers. If> > the drs  refer a pt to their MRI, and the cost
is 
4000 the pt in > >  actuality> > may be> > able to go to another center for 
3000  dollars.> > There are several wonderful sites on the net to explain  
updates > > as , they> > are added all the time.> >> >  In a message dated
8/22/2008 
10:35:55 P.M. Eastern Daylight Time,> >  stephanie2u at optonline.net writes:> 
>> > Can you restate that in a  complete thought? I am interested in> > 
understanding your point of  view. In particular, I'd like to hear> > about
the 
Stark/anti-kickback  law.> >> > Thanks,> >> > Stephanie> >> >  On Aug 22,
2008, at 
5:24 PM, margienp at aol.com wrote:> >> >> Why  you not read the 
Stark/antikickback law. I think if the> >> pharmacy  is referring. I do not
have to lighten up 
, this is> >> america the  last time I checked!> >> You go right ahead and 
get them in the  phamacy.> >>> >>> >> -----Original Message----->  >> From:
jane 
<npjane at bayspringstel.net>> >> To: NP Info  <npinfo at nurse.net>> >> Sent:
Fri, 
22 Aug 2008 10:07 am>  >> Subject: Re: [NPInfo] pharmacist and injections> 
>>>  >>> >> Lighten up, it's their libility and the more people that  get
the> 
>> flu shots the better. It is much easier and cheaper for  some people> >>
to 
get them from the pharmacy as they are already  getting their> >> meds
there. 
Some pharmacies here do it and I am all  for it. Since,> >> I am retiring, 
soon, I may get mine from them in  the future, who> >> knows.?> >> Jane
Johnson 
FNP ?>  >> _______________________________________________?> >> NPInfo
mailing 
list?> >> NPInfo at nurse.net?> >>  
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