Pharmacy Dispensing Fee Reimbursement
From the Minnesota Retailers Association: The CMS outpatient drug rule pharmacy reimbursement language and proposal for compliance with federal law was not included in Gov. Dayton's budget proposal.
The Minnesota Retailers Association (MnRA) is working with Administration officials and other stakeholders proactively on next steps to ensure this important measure is included is budgetary discussions this session. MPhA is also monitoring this issue.
As a reminder, to comply with the final pharmacy reimbursement ruling from Center for Medicare and Medicaid Services (CMS), last year the Minnesota Department of Human Services (DHS) outlined the following methodology:
Pharmacy Reimbursement - RETAIL AND LTC
- Acquisition Cost reimbursements:
- NADAC for generic and brand
- WAC -2 % for drugs without NADAC
- SMAC for multi-score drugs
- Dispensing Fee Component reimbursements: $11.35
- MN Wholesale Drug Tax on legend Drugs
- +2% add on to the acquisition cost component
- Would sunset in 2020 with current wholesale drug tax legislation
- Acquisition Cost Component reimbursements:
- Existing specialty SMAC, Updated at least monthly
- Dispensing Fee reimbursements:
- Wholesale Drug Tax on legend Drugs
- +2% add on to the acquisition cost component
- Would sunset in 2020 with current wholesale drug tax legislation
Pharmacy Reimbursement OTC Drugs
- Acquisition Cost Component reimbursements:
- NADAC if available, or SMAC
- Existing dispute process for SMAC
- Dispensing Fee Component
- $11.35 per prescription when entire manufacturer's package is dispensed.
- Prorated dispensing fee for quantities less than the manufactures package. (current law pharmacy must dispense entire package in most cases.)
Annual Financial Impact by (Pharmacy Type)
- Retail Increase 4.7%
- LTC Increase 5.9%
- Rural Independent Pharmacies Increase 5.2%
- Overall Total increase 2.5%
Annual Financial Impact by (Prescription Type)
- Specialty Drug increase 2.6%
- Non-specialty brands decrease 1.1%
- Generic Legend increase 14.6%
- OTC Drugs increase 42.5%
TOTAL FISCAL NOTE STATE IMPACT AT LEGISLATURE
- $3.25 approximately.
- $6.5 million overall shared equally (state & federal)
Uniform State Labor Standards Passes House Committee
From the Minnesota Retailers Association: After four hours of testimony, HF 600 (the Uniform State Labor Standards Act) passed out of the House Jobs Committee and was sent to its next committee stop. Several retailers, MnRA and others provided testimony surrounding the difficulties created by a patchwork of local labor regulations. MnRA Board Members Steve Rush, Holiday Companies, and Dave Reuter, Thrifty White Pharmacy, provided House Committee members context surrounding the importance of a statewide approach to labor law uniformity.
MnRA Government Relations Director and Legal Counsel Brian Carr told Committee members during his testimony, "Retailers will be greatly impacted by the new significant increase in their administrative duty to comply with an additional third layer of local labor laws, in addition to already complying with state and federal law." HF 600 would preempt local municipalities from establishing independent policies on wage, leave, and scheduling by solidifying the State has the sole authority to act in these areas. See MnRA's press statement thanking legislators in both parties for beginning the conversation on labor law uniformity.
News from MPhA
Board of Directors Seeks Nominations for Directors
Volunteers are at the heart and soul of MPhA‘s work. Contributions of volunteer time and expertise support MPhA’s advocacy agenda and allow us to provide essential information and unique education through our annual conferences, regional town hall events and monthly webinars. Serving on the MPhA Board of Directors is an opportunity to provide leadership and direction to the association as we strive to meet our mission: Serving Minnesota pharmacists to advance patient care. With health reform changes being considered and our expanded scope of practice initiatives, it is a very exciting time to be at the table to discuss the changes that are occurring and help chart the course for the profession.
The MPhA Leadership Development Committee is looking for members who are interested to serve on the Board of Directors and begin a two-year term in June 2017. We need the best skills, passion, and varied perspectives to build an energetic, inclusive, and strategic governing Board.
If this interests you, please fill out the online Call for Nominations form.
The deadline for submitting your nomination is Friday, February 17.
Support the MPhA Advocacy Fund
As previously reported in Small Doses, Buck Humphrey has been retained under contract to proactively promote the advocacy agenda of the Pharmacy Advocacy Task Force (PATF) through the 2017 session of the Minnesota Legislature. This financial lobbying commitment is being shared equally by MPhA and the Minnesota Society of Health-System Pharmacists. Because of the good-faith commitment we have made, we need a commitment from you! Please participate in the education of our citizens and our legislators — and contribute financially to our important work! Read more and donate now.
Just yesterday (Feb. 9), Buck Humphrey and Julie Johnson met with the Minnesota Medical Association to discuss pharmacy issues.
MPhA Leaders Speak at MPSA
Many thanks to MPhA Past President Jeff Lindoo and MPhA Board Member Ryan Chaffee for speaking to the Minnesota Pharmacy Student Alliance (MPSA) on Thursday, Feb. 9. Jeff and Ryan promoted attendance by students at Minnesota Pharmacy Legislative Day. There is still time to register!
You Never Know Who You’ll Meet at the Capitol
While meeting with Lauren Gilchrist, Senior Policy Advisor to Gov. Mark Dayton and Lt. Gov. Tina Smith, MPhA members met University of Minnesota Football Coach P.J. Fleck and his wife at the governor’s office. Left to right: Jeff Lindoo, Michelle Aytay, P.J. Fleck, Buck Humphrey, and Heather Fleck.
Many thanks to Michelle Aytay for providing us with all the photos in this week’s newsletter!
Changes in the Pharmacist & Technician Workforce in Licensed Minnesota Pharmacies
The latest report from Jon C. Schommer, PhD, RPh, and other colleagues from the University of Minnesota College of Pharmacy shows that the pharmacy labor market remained dynamic over the decade spanning 2006 to 2016, in terms of dependence on part-time labor, relatively high turnover, fluctuations in hourly wages, and changes in expectations for pharmacy hiring of pharmacists and technicians over time. Read the full report in the Winter issue of the Minnesota Pharmacist.
Use Your Member Benefits
Get Smart about Your Student Loan Repayment Options: MPhA Membership Benefit
When most pharmacists begin practicing, they’ve incurred steep education debt. When pharmacist borrowers learn about loan relief programs and correctly implement them, they reduce a major source of stress and save thousands of dollars on their student loans. MPhA is partnering with Navigate, LLC for student loan expert advice.
Through this benefit you will discover:
- Is Public Service Loan Forgiveness right for me?
- Will the new Revised Pay As You Earn repayment plan lower my payments?
- Does private consolidation and refinance make sense for my situation?
Schedule your student loan consultation today. MPhA members receive over 50% off regular rates. A regular public service loan consult would be $1,000 — but MPhA members are able to receive this consult for $395. A regular loan refinance consult would be $500 but MPhA members are able to receive this service for $195. That’s a savings of $305-$605 and provides an incredible return on your MPhA membership investment. Satisfaction is guaranteed!
Navigate’s principal, Joy Sorenson Navarre, is a national expert on student loan management who consults individually with physicians and pharmacists. She is a popular speaker at residency programs, medical schools and hospitals. Her articles appear in journals and websites throughout the medical community.
Schedule your phone appointment today. Get smart about your student loan repayment options and take advantage of this important MPhA member benefit!
Compliance Readiness Tools
Check out InfiniTrak’s Podcast Series about the Drug Supply Chain Security Act
The latest episode of the Pharmacy Podcast brings you more Drug Supply Chain Security Act (DSCSA) education with InfiniTrak’s Denise Garcia sharing her latest insights on the law and how InfiniTrak brings a cost-effective software solution to track and trace requirements that put you in the driver’s seat, controlling your information, ensuring your compliance, and freeing up your time to spend with patients.
MPhA has partnered with InfiniTrak, the premiere cloud-based software-as-a-service DSCSA compliance solution to ensure you have the latest information regarding the law and the opportunity to have access to their affordable DSCSA Compliance solution at an additional discount. CLICK HERE to register today or use Affiliation Code 7624e when subscribing. For more information on the DSCSA, be sure to check out MPhA’s on-demand Virtual Coffee Break Webinar on Fakes and Frauds in the Pharmacy (another free benefit of MPhA membership!).
Complimentary On-Demand Virtual Coffee Break Webinars Available to MPhA Members
MPhA offers monthly educational webinars that provide you with education from experts on best practices, trends, effective solutions, and quality resources to help you advance your career as an pharmacy professional. E-learning is ideal for those who are unable to travel or are looking for educational opportunities in between conferences. The program provides opportunities to obtain CEs from the comfort of your home or office with both live and on-demand options. View the archive. These webinars are free for MPhA members — another benefit of membership!
Special Offer for MPhA Members: Individual Subscriptions to PharmacyLibrary Online References for You and Your Practice
MPhA is pleased to partner with the American Pharmacists Association to offer MPhA members a discounted subscription rate for the PharmacyLibrary — the leading collection of online pharmacy resources, updated monthly. The cost of even two of the more than 30 leading references for pharmacy are more than the discounted rate for the entire online library! A few of the references include:
- Building Core Competencies in Pharmacy Informatics
- Communication Skills for Pharmacists, third edition
- Community Pharmacy Practice Case Studies
- Complete Math Review for Pharmacy, third edition
- Essentials of Cultural Competence in Pharmacy Practice
To take advantage of the special rate of $224.99 — a 40% discount off the regular rate — MPhA members should go to https://store.pharmacylibrary.com and enter promo code MPhA at checkout.
CDC Releases Updated ACIP Immunization Recommendations
From Pharmacy Times: The CDC has released its final 2017 updated adult vaccination recommendations approved by the Advisory Committee on Immunization Practices (ACIP).
The guidelines include information on the use of influenza, human papillomavirus (HPV), hepatitis B (HBV), and meningococcal vaccines. Among the updated changes include modifications to flu vaccines for individuals with egg allergies and details on vaccinating at-risk populations. Some of the key changes in the final guidelines:
- The recommendations on HBV vaccinations have been updated. The guidelines now recommend that adults with HCV infection, or other chronic liver conditions, and liver function enzyme levels twice the upper limit should be vaccinated. The presence of an immunocompromising condition is no longer a specific indication for HBV vaccination.
- ACIP advises against use of LAIV during the 2016-2017 influenza season.
- Adults with only hives as mild egg allergy symptoms should be given age-appropriate inactivated flu vaccine or recombinant vaccine. Individuals with severe symptoms should be vaccinated in a medical setting.
Read the full article
Sen. Brown Submits DIR Question as Part of Confirmation Hearing for HHS Nominee
From National Community Pharmacists Association Advocacy Center Update: Rep. Tom Price (R-Ga.), President Trump's nominee to lead the Department of Health and Human Services (HHS) testified last week before the Senate Finance Committee. At NCPA’s request, independent pharmacy champion Sen. Sherrod Brown (D-OH) submitted a question on DIR fees and pending CMS guidance for the record and Rep. Price provided an answer.
Question: Will you commit to supporting the finalization of such guidance? Are there other things you would do to ensure pharmacies have the information they need – in real time – to best serve their beneficiaries? If so, what are they?
Answer: If confirmed, I will look forward to working with you to consider how to resolve this pending guidance issue. Incidentally, I understand that on January 19, 2017, CMS released a fact sheet with information about recent trends in drug costs and Direct and Indirect Remuneration (DIR) under Medicare Part D.
On a related note, Rep. Price provided a response in regards to pharmacist provider status that he would be open to all options to address the impact of the ongoing physician shortage in rural areas. Rep. Price was approved as HHS Secretary earlier today.
Proposed 340B Mega-Guidance Withdrawn
From National Community Pharmacists Association Advocacy Center Update: On January 30, the Health Resources Services Administration (HRSA) withdrew its so-called “mega-guidance” for the 340B program that would have tightened rules on which providers, patients, and drugs would be eligible for discounts on prescription drugs. NCPA was pleased that the proposed guidance, first issued in August 2015, did not fundamentally alter or limit the contract pharmacy program.
However, NCPA expressed several concerns during the comment period, including a proposed new six-pronged definition of eligible patient—which was doubled from three—and a definition of outpatient drug that could bar 340B discounts for infusion drugs if they were prescribed outside of the hospital setting. Another concern was a provision that would have prohibited contract pharmacies from being able to dispense 340B drugs for Medicaid fee for service or Medicaid managed care organization patients unless there was a written agreement between the pharmacy and the managed care organization. That likely would have meant that contract pharmacies would have to exclude all managed care Medicaid as they currently do for fee for service. It remains to be seen whether HRSA will reissue another round of guidance, or if there may be congressional attempts to make statutory changes with the current focus on drug prices.
Register Now for Next Week’s Pharmacy Legislative Day!
Don't Forget Your White Coat!
Immediately following meetings with legislators, all attendees will gather in the Capitol Rotunda for a “Paint it White” group photo. It’s awesome to see so many pharmacists, easily identified by their white coats, throughout the Capitol.
Minnesota Pharmacy Legislative Day is one of our most popular advocacy and educational events all year! Join us on Wednesday, Feb. 15, 2017, at the newly renovated Best Western Capitol Ridge, just a few short blocks from the Minnesota Capitol. Our excellent line-up of speakers includes Heidi Ecker, Director of Government Affairs and Grassroots Advocacy for the National Association of Chain Drug Stores. Whether you are new to advocacy and politics or an experienced pharmacy advocate, this event is for you! We already have nearly 170 attendees registered (the record is in sight)!
Sponsor Pharmacy Legislative Day
Join Us at Midwest Pharmacy Expo Next Week!
This year’s Midwest Pharmacy Expo agenda features up to 15.5 hours of the high-quality, live CPE that Expo is known for, including pharmacy law and patient safety topics.
Expo starts with the Ambulatory Care Advancement Conference on Friday, February 17, 2017, discussing hot topics and emerging issues facing ambulatory care practice and promote forward-thinking pharmacy practice models that integrate pharmacists on the ambulatory healthcare team.
Expo Saturday will feature a keynote by Bob Chiusano, author of Mediocrity is Not an Option, to get the day off to an inspiring start! After that, enjoy five breakout sessions featuring 3 tracks for pharmacists: Current News Headlines, Clinical Pearls, and Management.
Expo will wrap up on Sunday with long-time favorites New Drug Update and Gamechangers with a review of compliancy issues sandwiched between them. All of this plus the opportunity to network with colleagues from across the Midwest! See the full agenda and register today!
Register Now for MPhA’s Next Virtual Coffee Break
Join us on Wednesday, February 22, for a webinar presentation (free to all MPhA members!) on anticoagulation. Speaker Kiersten Anderson, PharmD, BCPS, Senior Medical Science Liaison with The Janssen Pharmaceutical Companies of Johnson and Johnson, will review the history of anticoagulation, the most recent guidelines and data on treating patients with atrial fibrillation and venous thromboembolism.
Register Now for APhA’s Pharmacy-Based Immunization Delivery Certificate Training Program
Join us on Sunday, April 30, for this full-day training program! This innovative, intensive, and practice-based continuing pharmacy education is based on national educational standards for immunization training from the Centers for Disease Control and Prevention. This program is designed to educate pharmacists about the professional opportunities for vaccine advocacy and administration. This practice-based curriculum represents a fusion of science and clinical pharmacy. The program, which emphasizes a health care team approach, seeks to foster the implementation of interventions that will promote disease prevention and public health.
Register Now for APhA’s MTM Certificate Training Program
Delivering Medication Therapy Management Services
Join us on Thursday, May 4, for a full-day training program that qualifies you to register as a provider with Minnesota Medicaid and conduct and receive payment for Medication Therapy Management services. The program will be held at the Ewald Conference Center, 1000 Westgate Dr., St. Paul.
Our facilitators will be Jordan Wolf, PharmD, Certified Geriatric Pharmacist, Consultant Pharmacist, Thrifty White Pharmacy, and Michelle A. Johnson, BCACP, Pharmacist, Fairview Pharmacy Services. APhA’s Delivering Medication Therapy Management Services certificate training program has three components: online interactive self-study with assessment; the live seminar with online evaluation; and post-seminar case exercise. A Certificate of Achievement will be awarded to participants who successfully complete all program components, including an evaluation. Register no later than April 1 to get started on the self-study portion of the program!