Hurricane Emergency Preparedness Update:
- Healthcare Ready has activated the RxOpen map for Hurricane Irma. They will be actively tracking the storm and standing by ready to assist with requests for information or assistance, and information sharing. If you have partners or colleagues in the affected areas that might want to connect with them, or need assistance, feel free to contact Healthcare Ready for assistance at alerts@healthcareready.org or 1.866.247.2694. Healthcare Ready’s Rx Open is an interactive map that helps patients and providers find nearby open pharmacies in areas impacted by disaster. The map will be updated daily throughout the federally-declared disaster. If pharmacies find their status is not consistent with what is shown on Rx Open, please notify Healthcare Ready at ContactUs@HealthcareReady.org.
- Emergency Preparedness Refill Too Soon Edit Override: Reminder: In August 2016, NCPDP members approved the most effective method for overriding refill too soon type reject during a disaster: using the Submission Clarification Code 13 – Payer-Recognized Emergency/Disaster Assistance Request. The pharmacist is indicating that an override is needed based on an emergency/disaster situation recognized by the payer.
- Hurricane Harvey Update: Surescripts and Allscripts are providing for the response to Hurricane Harvey: pharmacists in areas under a federal disaster or emergency declaration due to Hurricane Harvey can access patient-specific medication history data free of charge.
MedPAC Addresses Role of PBMs and Specialty Pharmacies: On September 7, 2017, the Medicare Payment Advisory Commission (MedPAC) convened a public meeting to consider issues including: (1) telehealth services; (2) the role of pharmacy benefit managers (PBM) and specialty pharmacies; and (3) ways to encourage Medicare beneficiaries to use high quality post-acute care (PAC) providers. There were no votes or recommendations presented during the sessions. Telehealth issues will be examined extensively during the 2017/2018 meeting cycle, and the Commissioners indicated that they would also take-up PBM and specialty pharmacy issues and post-acute care discharge issues later this cycle as well. The PBM/specialty pharmacy session was intended to provide technical background on drug supply chain issues to the Commission. Many Commissioners commented on the complexity of the issues raised during the presentation, including specialty drug coverage, direct remuneration reporting, and PBM ownership of specialty pharmacies, and suggested that some of these issues be examined separately in future sessions. The Commission also discussed policy issues including the role of exclusive specialty pharmacy networks in Part D, PBM transparency rules, and whether MA prescription drug plans should manage specialty drugs that are under the medical benefit. NCPA will continue to meet with MedPAC to discuss our experiences and concerns with PBMs, DIR fees, and issues surrounding specialty networks.
Compounding Update: This week, pharmacy champion Congressman Buddy Carter fought for the rights of compounding pharmacists by pushing for an amendment to HR 3354 (the House “minibus” spending bill) that would have withheld funding for FDA to move forward with implementation and enforcement of a MOU that redefines “distribution” to include “dispensing.” The amendment was ultimately voted down, but the good news is that along with Congressman Carter 140 Members of Congress also voted to protect patient access to compounds. Also, the number of cosponsors on compounding legislation (HR 2871) has increased from 18 to 26 since the amendment was announced. NCPA will continue to fight for patient access to compounds and there will be other opportunities to ensure FDA follows the intent of Congress in implementing DQSA.
NCPA Grassroots Update: The month of August was very productive from a grassroots standpoint. While members of Congress were away from Washington and working in their respective districts, 17 members of Congress either visited an independent pharmacy or otherwise met with independent pharmacists during the month. Additionally, more than 900 emails were sent through the NCPA Legislative Action Center and countless calls were made urging members of Congress to support independent pharmacy’s legislative priorities.
NCPA Shares Pharmacy Concerns With DEA: Representatives from NCPA met with Drug Enforcement Administration officials recently, giving examples of policy changes and clarifications that would benefit pharmacy workflow and reduce financial and operational burdens for pharmacies. Among the topics discussed: finalizing guidance on e-prescribing for controlled substances, take-backs of controlled substances and partial fills. The meeting was in response to President Donald Trump’s Executive Order 13777 on regulatory reform. NCPA will be providing additional information to the DEA in order to reduce burdens on small business community pharmacies.
NCPA Offers Tax Reform Recommendations: NCPA sent a letter to House and Senate leaders as Congress returns and the tax reform discussions heat up. In the letter, we make the case for tax parity for small business independent pharmacies.
NCPA Weighs in with Pharmacy Orgs Regarding Physician Value-Based Payment Programs: Recently, NCPA, along with APhA, AMCP and ASCP, weighed in with CMS with recommendation on how to better incorporate pharmacist services into Alternative Payment Models. CMS included metrics in the 2016 final MACRA rule that specifically mention pharmacists—including a medication reconciliation post-discharge measure and the implementation of medication management practice improvements that recognize physician practices for “integrating a pharmacist into the care team.” We recommended that CMS incorporate and/or test an APM model focused on optimizing medication use and health outcomes as part of coordinated care delivery through the use of pharmacists. In addition, consideration should be given to how reporting systems can meaningfully capture the contributions of various health care practitioners, including pharmacists, to improving quality outcomes and managing costs. We also supported the comments submitted by the Pharmacy Health Information Technology (PHIT) Collaborative, focused on implementation of the Pharmacist eCare Plan which will be instrumental in facilitating standardized, interoperable exchange of pharmacists’ medication-related activities, plans and goals for patients. Not having pharmacists’ contributions documented in the EHR infrastructure also minimizes the ability to measure the value they provide as well.
New State Resource: Medical Marijuana and the Pharmacist’s Role: If your state is contemplating medical marijuana legislation, you’ll want to check out NCPA’s new one-pager on medical marijuana legislation and the role of pharmacists. Although 29 states have legalized marijuana for medical use, only five states have established a role for pharmacists in the dispensing/counseling process. Still, conflicts with federal law can create legal and professional issues for pharmacists who choose to offer marijuana-related services. Our informational document highlights issues that should be considered by state lawmakers as they draft medical marijuana legislation to ensure the pharmacist-patient relationship is preserved.
