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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
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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
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Regulation
of Rx discount
cards
PBM
transparency in state
contracts
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All
eyes on Washington, D.C. this week NCPA
committee forum, PAC telethon & health care
reform legislation
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This week will be one of the most, if not THE
most eventful weeks in this country's history. All
eyes are on Washington, D.C. where a vote is
expected on final passage health care reform
legislation. And I'm heading into the middle of it
for the National Community Pharmacists Association
annual committee forum. This is the
meeting at which a small group of members
representing your interests determine what we want
NCPA to try to accomplish this year for
independent pharmacy. The NCPA steering
committees cover communications, compounding, home
health, long-term care, innovation/technology,
management, multiple locations, national
legislation and government affairs, patient care
and third party issues. I'm participating as chair
of the National Legislation Committee. All of this
is, in part, preparation for the National Legislation and
Government Affairs Conference May 10-12 in
Washington, D.C. Prior to our meeting, we
will be participating in a telethon to raise money
for the NCPA political action committee. Thanks to
you, in just five years this PAC has risen from
963rd to the 40th largest association PAC in the
country. This means you and your fellow
independent community pharmacists perceive the
problems you are facing as serious enough to
warrant your financial input. We can't stop now.
With so much at risk, when have we had more need
to keep our supporters in office? Also
this week, House Speaker Nancy Pelosi hopes to
nail down the 216 votes from House Democrats
needed for passage of a health reform bill. The
plan is for the House to take up the Senate's
health care reform bill that passed Christmas Eve
which, on balance, is better for community
pharmacy both on health care and business related
issues as compared to the House bill that passed
last November. The Senate and House would then
make changes to the Senate bill through the
now-famous reconciliation process. With respect to community
pharmacy, the health care reform bill, if enacted
into law, would:
- Reform the
Medicaid pharmacy reimbursement system by
assuring that only sales to community retail
pharmacies would be included in the definition
of average manufacturers price (AMP). It
also would set reimbursement for federal upper
limits (FULs) for generics at 175 percent of the
weighted average AMP;
- Provide for an
exemption from DME accreditation for certain
pharmacies whose Medicare DMEPOS billings are 5
percent or less of total pharmacy sales;
- Require
transparency for PBMs under contracts to plan in
the health insurance exchanges;
- Expand
Medicaid coverage to individuals up to 133
percent of the federal poverty level;
- Create a grant
program for pharmacies to help test new
innovative methods to provide medication therapy
management;
- Close the
Medicare Part D donut hole over a number of
years through new federal funds as well as
discounts from pharmaceutical
manufacturers;
- Require Part D
plans to use specific dispensing techniques to
reduce pharmaceutical waste in long-term care
facilities.
Stay
tuned!
 Richard E. Beck,
RPh Executive Director, Texas Pharmacy Business
Council
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Federal employees forced
to use CVS stores |
Once
again, CVS/Caremark is providing fodder for the
Federal Trade Commission's investigation into the
pharmacy/PBM merger. One of our member pharmacies
reports a patient of his, who can only get a
90-day prescription supply by mail order, is now
being told he can get the same lower rate at a CVS
store. And when the federal employee tried to
refill a prescription at the independent community
pharmacy, Caremark rejected the claim because a
maximum number of refills via a local pharmacy has
been exceeded and the patient must use mail order.
Forcing federal employees into this
arrangement would be prohibited by HR 4489, the
bill I testified about last month on behalf of the
National Community Pharmacists Association. The
bill ensures program integrity, transparency and
cost savings in the pricing and contracting of
prescription drug benefits under the Federal
Employees Health Benefits Program.
We
have shared this information with bill sponsor
Stephen Lynch (D-MA). We need information on other
incidents like this. If you have experienced this,
please send us detailed
information:
- Which federal agency your patient works for.
- Whether the patient will permit his or her
name to be used.
- If possible, a short signed story from the
patient about his or her
experience.
This information
will be very helpful for passing HR
4489.
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Senator probes
pharmaceutical industry via PBMs &
PCMA
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The PBM-pharmaceutical
industry partnership is a target of U.S. Senator
Chuck Grassley (R-IA), the ranking Republican on
the Senate Finance
Committee. He sent the two largest
PBMs and the Pharmaceutical Care Management
Association letters last week asking them to
provide information about their financial
relationships with drugmakers. This week, he sent
letters to Express Scripts, CVS Caremark and the
Pharmaceutical Care Management
Association.
Senator Grassley's letter
notes that a report last year by the Medicare
Payment Advisory Commission (MedPAC) recommended
that Congress should require drugmakers to report
their financial relationships with pharmacy
benefit managers, pharmacies, health plans and
others, but not rebates or discounts.
And
so he asks for details about steps taken that
would enhance transparency of "financial benefits"
that may be provided by drugmakers. This includes
MedPAC's proposal that payments or transfers of
value, such as gifts, travel, honoraria,
consulting fees and investment or ownership
interests should be revealed, excluding reporting
of rebates and discounts. Senator Grassley likened
the requirement to the stipulations found in the
Physician Payments Sunshine Act, which he and
Senator Herb Kohl (D-WI) introduced that requires
drug and device makers disclose anything of value
given to doctors and post the info on Web
sites. | |
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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 | | |
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