Consultant Pharmacist Disclosure Agreement Model

In October 2011, the Centers for Medicare and Medicaid Services (CMS) proposed a new regulation which would require the separation of the consultant pharmacist from the dispensing pharmacy. The LTC industry responded to the proposed regulation, and ultimately CMS indicated that the agency would not proceed to finalize the regulation as outlined. The final rule, entitled “Medicare Program; Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2013 and Other Changes,” is available online in the Federal Register.

CMS stated in the final rule that the agency continues to have concerns regarding potential conflicts of interest related to relationships consultants may have between the dispensing pharmacy, pharmaceutical manufacturers and distributors, or any affiliates of these entities.

To this end, CMS strongly encouraged the LTC industry to voluntarily adopt the following changes to increase transparency:

  1. Separate contracting for LTC consulting services from dispensing and other pharmacy services;
  2. Payment of fair market rates by LTC facilities for consultant pharmacist services;
  3. Disclosure by the consultant pharmacists to the LTC facility of any affiliations that would pose potential conflicts of interest; or the execution of an integrity agreement by consultant pharmacists.

NCPA has drafted a model disclosure agreement to help pharmacists share potential conflict of interest information with the LTC facility. The model language is for example purposes only and NCPA recommends that you seek the advice of legal counsel to review agreements specific to your business. A new disclosure agreement should be executed on an annual basis.

Click here to login and to download a copy of the model disclosure agreement in Word format.

Contact Information

NCPA Headquarters
100 Daingerfield Rd
Alexandria, Va 22314

(800) 544-7447
Contact us by email:
This email address is being protected from spambots. You need JavaScript enabled to view it.












Smith Drug



Sponsor Highlights

Back to Top