Consolidated Mail Outpatient Pharmacy
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The Consolidated Mail Outpatient Pharmacy (CMOP) is an initiative by the United States Department of Veterans Affairs to provide mail order prescriptions to veterans using computerization at strategic locations throughout the country.
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[edit] History
During the 1970s and 1980s, the VA began experimenting with the consolidation of mail prescription workloads. By 1994, it was ready for a computerized test project. Leavenworth, Kansas was the site of the first CMOP, and it handled a high volume of prescription utilizing robotics to automate dispensing of medications.
The CMOP program is now serving the entire country from a number of locations including West Los Angeles, California, Bedford, Massachusetts, Dallas, Texas, Hines, Illinois, Charleston, South Carolina, and Murfreesboro, Tennessee.
[edit] Operations
The CMOP program fills continuation of therapy or refill prescriptions only. Initial prescriptions are written for veterans at one of the Veteran Administration’s health care facilities. When a refill is needed, the heath care facilities process the prescriptions. The CMOP then uploads this information from multiple facilities in its region. Once filled, the US Postal Service delivers the prescriptions. The health care facility or clinic is notified of the prescription’s completion electronically. As of 2000, the annual workload was near 50 million prescriptions. Processing and filling prescriptions took two days; three more days were required for mail delivery.
[edit] Government efficiencies
Because of congressional interest in exploring if CMOP could provide cost savings for Department of Defense beneficiaries picking up outpatient refill prescriptions from military treatment facilities, the DOD and VA conducted a pilot program in FY 2003. In its 2005 report, GAO-05-555, the Government Accountability Office (GAO) found that the DOD could generate savings because CMOP's size allows it to negotiate volume discounts.
[edit] Controversies
On 29 November 2005, two employees at the Murfreesboro, Tennessee CMOP, Joseph Haymond and Natalie Coker, were indicted for accepting kickbacks from a vendor selling red tape. In addition, vendor R. Michael Walsh was indicted.
From about August 1999 to July 2001, R Michael Walsh sold more than 100,000 rolls of red tape to the CMOP. Walsh paid his supplier about $2.50 per roll of tape, but Haymond instructed Walsh to charge the CMOP $6.51 per roll, a markup of more than 150%, and to give Haymond and Coker a kickback of $1.00 each for every roll of tape he sold to the CMOP. Coker and Haymond instructed CMOP employees to buy the tape in increments of less than $2,500 so that the CMOP employees could use their government credit cards, thereby avoiding using the VA’s Acquisition Service Center. Coker and Haymond each received more than $100,000 in kickbacks from Walsh related to the red tape he sold to the CMOP at inflated prices.
On 30 November 2005, Haymond died of a self-inflicted gunshot wound outside his home in Auburntown, Tennessee. The case against him was dismissed on 7 December 2005.
On 24 March 2006, Walsh plead guilty to one count of Conspiracy to Defraud the United States.
Coker was charged with one count of conspiracy to defraud the United States, three counts of acceptance of bribes by a public official and one count of having a conflict of interest by participating as a government official in a matter involving a company with whom she was negotiating for prospective employment in violation of Title 18, United States Code, Sections 371, 201(b)(2) and 208(a) and 216(a)(2), respectively. On 24 March 2006, Coker plead guilty to the conflict of interest charge.
[edit] Sources
US House of Representatives, Committee on Veterans Affairs, Subcommittee on Oversight and Investigations. May 25, 2000. Testimony of John E. Ogden, M.S. Chief Consultant for Pharmacy Benefits Management, Department of Veterans Affairs. VA’s Consolidated Mail Output Pharmacy Program.
United States of America v. Joseph Haymond, Case 3:05–03107. United States District Court, Middle Tennessee District, Nashville Division.
United States of America v. Natalie Coker and R. Michael Walsh, Case 3:05-00232. United States District Court, Middle Tennessee District, Nashville Division.
"VA Suspect Takes Own Life". The Daily News Journal, Murfreesboro, Tennessee. 1 December 2005.
