What FWA and HIPAA Compliance Elements are Necessary for Interns, Job Shadows, Floating Staff, Cashiers and Delivery Drivers?

Safeguarding the pharmacy’s Protected Health Information (PHI) is a MUST for all staff expected to come in contact with this sensitive information. Requiring HIPAA training prior to interns, job shadows, or floating pharmacy staff stepping foot behind your pharmacy counter is one way to ensure they have a good grasp on appropriate safeguards and the negative repercussions (including civil monetary penalties and criminal consequences) of disclosing PHI. HIPAA compliance training is also required for any staff that may come into contact with PHI, which typically includes cashiers and delivery drivers. Additionally, if an employee has access behind the pharmacy counter, they need to be HIPAA trained.

Since interns, float staff, cashiers and delivery drivers are involved in daily pharmacy operations such as billing, filling, counseling, dispensing, delivery of services and/or other professional services, they must also complete Fraud, Waste and Abuse (FWA) training. They are in the pharmacy and have the potential to oversee (or even instigate) wasteful practices, diversion, or other fraudulent activities and FWA training must be completed.

Pharmacy staff who are contracted to deliver medications for your pharmacy, work on a temporary basis or simply float through your store are also subject to FWA and HIPAA training requirements. Whether these employees are hired directly by your pharmacy (or paid through a 1099), or they are contracted through a third-party staffing company, the burden is on the pharmacy owners/operators to ensure all members of their staff have received appropriate training.

Another safety measure for pharmacies is to perform exclusion checks against both the Office of Inspector General (OIG) and General Services Administration (GSA) lists prior to “hire” and monthly thereafter. This should be done for all staff involved in the billing, processing, handling, or delivery of prescriptions, including interns. Additionally, be sure all applicable local exclusion lists are appropriately checked and documented proof is readily retrievable (e.g., New York State Medicaid Exclusion list), in accordance with state laws. Floating and contracted staff must also be checked. Not only is hiring an excluded individual a direct violation of Medicare Part D contracts, but items or services involving an excluded individual in any way cannot receive reimbursement from Medicare or Medicaid. The pharmacy would also be required to pay up to $10,000 for each claim that the excluded individual was involved in as well as up to three times the damages incurred from these claims.

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  • Students performing a job shadow should have direct supervision and not be involved in pharmacy operations
  • Verify appropriate supervision requirements for pharmacy student interns with your state board of pharmacy
  • Exclusion list searches should be documented and retained for 10 years
    • Enter the hired person’s name into the exclusion review system exactly as it appears on their state or federally issued form of identification to ensure integrity of the check
      • Keep in mind, excluded individuals often try to hide their identity by changing their name or using a different name – don’t take a chance
  • PAAS FWA/HIPAA Compliance members can easily add students, interns, and floating staff to your employee list in the PAAS Member Portal, this will:
    • Give the shadow, intern or floating staff member access to the FWA and HIPAA online training modules
    • PAAS will automatically perform daily OIG and GSA exclusion checks when their profile is created

PAAS FWA/HIPAA Compliance members should modify the job shadow, intern, or floating staff member’s “termination date” when their time in your pharmacy ends to remove them from your list of active employees

Sara Hathaway, PharmD
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