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Texas
Pharmacy Business Council is an organization of
American Pharmacies and the Academy of Independent
Pharmacists-Texas.
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TDI pharmacy
help |
The
Texas Department of Insurance has a Pharmacist
Resource Page that includes links to complaint
forms and advises when the next Pharmacy Outreach
Conference Call will be held.
Add this link to your online
"favorites" list.
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Texas
legislation success
list |
Regulation
of Rx discount cards
PBM
transparency in state contracts
Mail
order
parity | | |
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We've
been called to big show
Taking our story
of PBM transparency success to
D.C.
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Is it too
early to use baseball metaphors? Actually, the
timing is just right and so is our success with
PBM transparency legislation. We've been called to
Washington to testify about how legislation passed
in Texas is saving tax dollars.
The
National Community Pharmacists Association has
asked me to come testify before the Subcommittee
on Federal Workforce, Postal Service, and the
District of Columbia that is debating HR 4489, the Federal Employees
Health Benefit Plan Prescription Drug Integrity,
Transparency, and Cost Savings Act of 2010. This
is a subcommittee of the Committee on Oversight
and Government Reform.
That was a mouthful
of committee names! Suffice it to say we will tell
them about the transparency mandates passed by the
Texas legislature in 2007 and 2009. Two state
agencies will see dramatic savings as a result of
transparency and rebate pass-through called for in
their PBM contracts. The Employees Retirement
System of Texas has contract with CVS/Caremark
with a projected savings of more than $200
million. The Teachers Retirement System of Texas
is in negotiations right now with CVS/Caremark on
the retired teachers drug benefits. With the
transparency requirements built into the RFP, they
too can expect multimillion dollar taxpayer
savings.
This proposed federal bill
dramatically overhauls prescription drug benefits
for 8 million federal employees, dependents, and
retirees who get their prescription drugs through
the variety of plans offered by the federal
government. Despite their agreement to
transparency in Texas state contracts, the PBMs
are really fighting changes in the federal
benefits package.
I don't see how the PBMs
stand a chance of denying the federal government
the same transparencies granted in Texas. It's
time to play the funeral march for PBMs. We all should be
proud of our years of effort in this
fight!
Stay
tuned!
Richard E. Beck,
RPh
Executive Director, Texas Pharmacy Business
Council
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TDI comes through for
pharmacy
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By Amanda
Fields
In response to a complaint
submitted by TPBC, the Texas Department of
Insurance informed Humana that its proposed 25
cent adjudication pharmacy claim processing fee is
prohibited by Texas law.
TPBC recently utilized TDI's newly
reformed complaint process and submitted a
complaint on behalf of independent pharmacy to
point out that Humana's proposed adjudication fee
was not allowed, based on SB 418 passed during the
78th legislative session. That bill, authored by
Sen. Jane Nelson (R-Flower Mound), became law in
2003! SB 418 provides for the regulation and
prompt payment of health care providers under
certain health benefit plans and established
penalties for violations of these regulations. One
aspect of SB 418 prohibits a health benefit plan
from directly or indirectly charging a fee for the
adjudication of an electronic claim. This
provision of SB 418 is now codified in the Texas
Insurance Code. Senator Nelson also sent a letter
to TDI in support of TPBC's complaint on this
issue.
TPBC is grateful to TDI
for its prompt resolution of our complaint, and
for enforcing the provisions in the Texas
Insurance Code that prohibit the charging of
adjudication fees.
If you are
currently being charged an adjudication fee, we
would like to know about it, and we encourage you
to use TDI's online complaint form
developed
for pharmacy. TDI has lots of information for pharmacists we
think you'll want to read.
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Texas
Pharmacy Business Council
Ensuring patient access to
quality pharmacy care services,
the viability of
community pharmacy and the pharmacy
profession.
1001
Congress Ave., Suite 250, Austin, TX 78701
512.992.1219
Richard
E. Beck,
RPh, Executive Director
www.TxRxCouncil.org | | |
Rep. Chuck Hopson, RPh is the best
friend independent pharmacy has in the Texas House of
Representatives. And he's been our friend for almost a
decade. Please consider the financial impact of the
increased Medicaid dispensing fee when you're deciding
how much to donate to Rep.
Hopson.
Don't you think you could send him
at least $250 per store?
