More Pharmacy Talk with the Feds

By Kevin Schweers

Top Democrats and Republicans in Congress and other senior federal officials shared their views on issues affecting pharmacy, during the second day of NCPA’s 2010 National Legislation and Government Affairs Conference.

U.S. Senator and Health Committee Chairman Tom Harkin (D-Iowa) cracked that, when it comes to Washington policymaking, “If you’re not at the table, you’re on the menu.” He added: “I can tell you that NCPA is always at the table and that’s a good thing.” Harkin lauded health care reform’s disclosure requirements for pharmacy benefit managers (PBMs); the closing of the “doughnut hole” coverage gap; expansion of medication therapy management and the 340B program; and DME accreditation exemption. And he commended community pharmacists’ role in keeping down health costs, saying, “When people take their medications it saves money and keeps them out of the hospital.”

Harkin’s fellow Senate Democrats Mark Pryor (D-Ark.) and Jon Tester (D-Mont.), U.S. Rep. Sander Levin (D-Mich.), Chairman of the Ways and Means Health Subcommittee, and Rima Cohen, JD, Counselor to the U.S. Secretary of Health and Human Services,  also addressed the gathering.

On the Republican side, U.S. Senator John Cornyn of Texas shared his family’s personal experiences with their local pharmacist. His mother took a variety of medications when she grew older. It was her pharmacist who helped her manage them all and who provided her with the comfort and information to deal with her health conditions. Sen. Cornyn also stressed the need for changing the U.S. health care system to focus on value over volume and implementing more properly aligned incentives.

“Community pharmacists are at the epicenter of coordinating care,” Cornyn said. “We need to find a way to share the savings with the people who coordinate the care.”

Other Republicans included U.S. Reps. Jo Ann Emerson (R-Mo.) and Wally Herger (R-Calif.), Ranking Member of the House Ways and Means Subcommittee.

Revised federal upper limits for Medicaid generic drug reimbursement – a key pharmacy provision in health care reform – should be in place around the start of 2011, predicted Joe Fine, a former Maryland state Medicaid official and now a senior official with the U.S. Centers for Medicare and Medicaid Services. Fine also expressed support for the concept of a reimbursement model that better reflected the pharmacist’s expertise and professional services rendered and less tied to the commodity (the prescribed drug). He cited Alabama’s work as an example.

Sandra Bastinelli, RN, of Medicare’s Centers for Program Integrity, spoke of the health reform law’s provision exempting most community pharmacies from accreditation requirements in the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) program. She also answered specific compliance questions raised by individual pharmacists and previewed the coming steps in Medicare’s DMEPOS competitive bidding program.

Independent community pharmacies are particularly critical in rural areas, according to Paul Moore, DPh and Senior Health Policy Advisor for the U.S. Health Resources and Services Administration (HRSA). HRSA’s Office of Rural Health Policy has done extensive research on rural pharmacy issues and documented a troubling net loss of 503 independently owned rural pharmacies from 2006 to 2008.

Moore added that expansion of the 340B prescription drug discount program in health care reform represents an opportunity for community pharmacies. Growth in 340B contract arrangements between clinics and pharmacies have increased significantly, he said, and provisions in health reform could fuel continued growth in the program.

Also featured were presentations from the U.S. Drug Enforcement Administration on the Controlled Substances Act and prescription drug disposal as well as the U.S. Food and Drug Administration on drug disposal, compounding and Risk Evaluation and Mitigation Strategies (REMS).

Previous posts in this series on NCPA’s Legislative Conference can be found here:

Pharmacists Hear from Senior Washington Officials at NCPA Conference

About those Mail Order Savings

A New Approach to Medicaid Reimbursement for Pharmacists

Roberts: Progress Made; More Battles Ahead; and Adherence is Critical

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