Small Doses Newsletter

March 4, 2016

MPhA Virtual Coffee Break
Online Webinar
Pharmacist Night Extravaganza
Rochester, MN
MN Pharmacy Legislative Day
St. Paul, MN

Breaking News

MPhA News

What MPhA Is Working on Now

Minnesota News

National News

Did You Know?

Breaking News

HITECH Administrative Matching Funds to Help Professionals and Hospitals Eligible for Medicaid EHR Incentive Payments Connect to Other Medicaid Providers

This is an opportunity to support state level efforts for the “initial on-boarding of pharmacies to HIEs or other interoperable systems…” The goal is to improve coordination of care between providers and across settings of care. As states consider ways to enhance their health IT infrastructure, please think of ways your organization can partner/collaborate with states to enhance data exchange and connectivity with pharmacies.

The Centers for Medicare & Medicaid Services (CMS) is issuing updated guidance on when state costs related to promoting Health Information Exchange (HIE) can be matched at the 90 percent HITECH administrative rate to support the coordination of care and transitions of care requirements in Meaningful Use modified Stage 2 and Stage 3.

The guidance is available at

MPhA Public Affairs Committee Report

With the 2016 Minnesota legislative session beginning on March 8, this will be a new heading in Small Doses. Watch for important updates during the next 10 to 12 weeks. MPhA’s Public Affairs Committee is already proactively working on pharmacy-related legislation and working to assure that your interests are represented at the Capitol. Read a summary of legislation that we are working on.

SF 1530/HF 1587 Freedom of Choice for Pharmacy Services
Requires health plans to allow any pharmacy to participate in a network contract, as long as they are willing and able to accept/meet the terms and conditions of the contract.
SF 1530
Authors: Hoffman, Metzen, Lourey, Sheran, Rosen.
Status: Passed all relevant Senate committees in 20105, re-referred to Commerce this year.
HF 1587
Authors: Hamilton, Atkins, Davids, Lien.
Status: Referred to Commerce Committee in 2015. No action.

SF ____(bill not yet introduced)/HF 2507 Pharmacist Prescribing of Naloxone
Allows pharmacists to prescribe and dispense naloxone.
HF 2507
Author: Barrett
No action. (But we believe the prospects for this bill are good.)

SF ____/HF 2512 Extended Medication Supply
Allows pharmacist to change the quantity on a prescription up to a 90-day supply without contacting the prescriber, as long as there are refills to cover and medication is not a controlled substance.
HF 2512
Author: R. Peterson
No action.

SF 1440/HF 1652 Modifications to the Prescription Monitoring Program
Allows the pharmacist and prescriber to access the PMP in situations other than when considering prescribing or filling a controlled substance prescription. Also allows the Board of Pharmacy to maintain PMP data for a longer period for trend analysis purposes.
SF 1440
Authors: Rosen, Eaton, Hoffman, Benson, Murphy.
Status: Passed all relevant committees in the Senate in 2015, returned to Judiciary Committee.
HF 1652
Authors: Baker, Clark.
Status: Passed HHS Reform and Civil Law & Data Practices Committees with several amendments modifying some of the access provisions and the length of time the Board can retain data in 2015. Re-referred (in error) to HHS Reform Committee. Several members of the House have significant concerns about data privacy around this bill. We will fight to maintain the Senate language.

SF 1425/HF 1503 Collection and Disposal of unused Medications by Pharmacies
Allows pharmacies to implement the DEA’s new rule for disposal of unused medications, including controlled substances, from the public and long-term care facilities.
SF 1425
Authors: Rosen, Eaton, Hoffman, Benson, Marty.
Status: Passed HHS Policy Committee in the Senate in 2015. Re-referred to HHS Policy.
HF 1503
Author: Barrett.
Status: Referred to HHS Policy Committee in 2015. No action.

SF 934/HF 1060 Prior Authorizations (From the Minnesota Medical Association)
Places limitations and requirements on PBMs and health plans on circumstances when prior authorization, step therapy, etc., can be placed on a drug and how the process must be handled.
SF 934
Authors: Franzen, Sheran, Rosen, Metzen, Marty.
Status: Passed HHS Policy, Commerce and State & Local Government Committees. Referred to HHS Finance.
HF 1060
Authors: Albright, Zerwas, Murphy, E., Gruenhagen, Dean, M., Schoen, Hamilton, Liebling, Uglem, Schultz, Lillie, Dill, Baker, Clark.
Status: Referred to HHS Reform, no action.

Medicaid Reimbursement
CMS released its 658-page Covered Outpatient Drug Rule in January, outlining how states are to reimburse pharmacies for prescription Drugs. MPhA is reviewing various interpretations of that rule and we have met with Sara Drake, Pharmacy Program Director for Minnesota Department of Human Services, to better understand the impact of that rule on Medicaid reimbursement in Minnesota. Even with 658 pages and an additional seven-page letter to State Medicaid Directors, some areas of the rule remain unclear.

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MPhA News

Are You Ready to Make a Difference?

Register Online

Join Us in St. Paul for Minnesota Pharmacy Legislative Day on April 5

Are you ready to make a difference — to advocate for your own professional interests and those of pharmacy to advance patient care? Come to Minnesota Pharmacy Legislative Day and learn how! Whether you have ever talked with, called or written your legislator or not, this event will give you the tools you need to do so. This year’s event will be held April 5, 2016, at the Securian Suite at CHS St. Paul Saints Baseball Stadium in Lowertown St. Paul (only 4 Green Line light rail stops to Minnesota’s Capitol!). More than 60 people have already registered — join them before we run out of space!

Minnesota Pharmacy Legislative Day is the one annual event that represents the voice of pharmacy in Minnesota! It is your opportunity to learn about the issues, gain the tools you need to advocate, and network with colleagues and the policymakers who will support pharmacy’s issues. The day is broken into a morning session, afternoon at the Capitol and an evening reception — providing meals throughout the day and more than 5 hours of continuing education.

Here are just a few of the great things that have been planned for attendees:

  • PRIME Institute Director Steve Schondelmeyer will lead the morning program with a primer on Advancing Action on Access & Affordability of Pharmaceuticals & Pharmacists’ Services. Steve will provide insights into the factors associated with prescription access and affordability and highlight key talking points that may be used with policymakers given the growing concern about prescription pricing.
  • Washington, DC’s Heidi Ann Ecker, Director of Government Affairs and Grassroots Programs for NACDS and orchestrator of the RxIMPACT grassroots programming, will lead “Effective Grassroots Involvement in the Policymaking Process,” a program to build your advocacy skills.
  • After learning about key issues and having lunch, you will take that knowledge to meetings with your representatives and senators at the Capitol in the afternoon. You will have the opportunity to go on visits with colleagues or student pharmacists by making this request during the registration process. So even if you have never met with a legislator before, you’ll get the tools you need to talk with them and other policymakers who will impact pharmacy’s legislative agenda in the coming years.

Round out the day networking with your peers at the evening reception followed by a facilitated discussion with key public policymakers who will impact pharmacy’s key 2016-2017 issues and health care in Minnesota. The program will provide more than 5 hours of CE for Pharmacists AND Pharmacy Technicians. A full schedule of the program can be found online.

Register Online Download Registration Form

This is the day to advocate for pharmacy practice to advance patient care. We look forward to seeing you on April 5!

Register Now for the March Virtual Coffee Break Webinar: HPV Vaccination Is Cancer Prevention — Changing the Conversation

Register Online

Our next webinar on March 16 will discuss the HPV virus, HPV vaccination, potential barriers to the HPV vaccination, the importance of a strong provider recommendation, and some common barriers providers face when suggesting a child be vaccinated against HPV. Minnesota pharmacists' scope of practice was broadened in the 2015 Legislative Session to include vaccination of adolescents aged 13 and over for the three-dose HPV vaccination series. This Virtual Coffee Break will provide pharmacists with important information as they move forward in offering the HPV vaccine to their patients.

About the Speaker:

Theresa Tranel

Theresa Tranel, PharmD, is currently a PGY1 Community Pharmacy Resident with the University of Iowa and Hy-Vee Drugstore in Iowa City, IA. She received her PharmD from Drake University in 2015. Her areas of interest include developing clinical services and disease state management in the community pharmacy setting. She is passionate about immunizations and specializes in providing travel immunizations through Hy-Vee's Travel Services Program at Hy-Vee Drugstore in Iowa City, IA.

The program is part of MPhA’s “3-3” Virtual Coffee Break series on the third day of the work week during the third week of the month to keep pharmacists, student pharmacists and pharmacy technicians current on cutting-edge topics presented by expert colleagues. The Virtual Coffee Break has a limited number of spaces, so sign up right away to ensure your spot.

Learning Objectives:
After participating in this webinar, attendees will be able to:

  • Describe the burden of HPV disease.
  • Define the importance of HPV vaccination for cancer prevention.
  • Explain the rationale for vaccinating youth at ages 11 or 12.
  • List the recommendations for administering the HPV vaccine to girls and to boys.
  • Provide useful and compelling information about HPV vaccine to parents to aid in making the decision to vaccinate.
  • Locate resources relevant to current immunization practice.

Continuing Education Credit: The Minnesota Pharmacists Association is accredited by the Minnesota Board of Pharmacy as a provider of continuing pharmacy education. This activity is approved for one credit hour.

Registration Fees: $10 for MPhA members and $25 for nonmembers. The webinar is complimentary for pharmacy students and residents.

Virtual Coffee Breaks Are Still Available for Viewing: We have archived Webinars on the Mitigating and Avoiding Conflict in Pharmacy Settings, ICD-10-CM, the Drug Supply Chain Security Act and the new track and trace requirements, ePrescribing, Specialty Pharmacy, Medicare Star Ratings and Hepatitis C treatments, which also carry one credit hour of CE each. You can access these programs at the MPhA Webinar archive. Each is available for one year following the live presentation.

Stay on Top of DSCSA with InfiniTrak and MPhA

Enforcement of DSCSA regulations has begun. The U.S. Food & Drug Administration’s (FDA’s) final guidance, released on Feb. 29, stated that the agency will not take action against first responders who fail to obtain tracing information — but affirmed that all others (including pharmacies) must now perform lot-level product tracing.

MPhA and InfiniTrak are partnering to help you get a solid, low-cost solution in place. InfiniTrak is extending its special pricing offer until the end of March. Until March 31, InfiniTrak’s full compliance solution is available for just $89/month.

Stay informed about trace and track by listening to free recorded webinars, “DSCSA: Debunking the Myths” and “Understanding the DSCSA and How it Impacts You”. The webinar includes responses to many frequently asked questions and specific questions posed by those calling in.

InfiniTrak Product Demo:
If the system asks you for a password, please use: InfiniTrak!

To subscribe to InfiniTrak, visit
For more information contact Sally Flynn at
Questions? Contact:
Want More Information? Visit:

Register Now! APhA’s Delivering Medication Therapy Management Services

Register Online

Registration is now open for APhA’s Delivering Medication Therapy Management Services seminar. The event will be held on Thursday, April 21, from 8 am until 5 pm at the Ewald Conference Center in St. Paul. The registration deadline is March 25 — and self-study must be completed before the live seminar.


This program qualifies you to register as a provider with MN Medicaid and conduct and receive payment for Medication Therapy Management services.

Seats are limited for this course. Submitting registration materials by March 25 does not guarantee a seat in the program. If space is still available, you will receive confirmation of your admission. If the program is closed, your credit card will not be charged, and you will be notified. Participants must complete the self-study component, attend the live training seminar, and complete the follow-up case studies to receive full credit and certification for this course.

To Receive Full Credit for this Course:
Participants must complete the self-study component;
Participants must attend the live training seminar;
Participants must complete 12 follow-up case studies.

APhA’s Delivering Medication Therapy Management Services Certificate training program (3rd Edition) presents a systematic approach for developing, implementing, delivering, and sustaining MTM services. It includes an overview of the marketplace for delivering MTM services, guidance for implementing MTM services in pharmacy practice, a review of the essential skills and knowledge needed for performing MTM successfully, and an organized process for identifying medication-related problems. The purpose of this certificate training program is to prepare pharmacists to improve medication use through the delivery of MTM services in a variety of practice settings.

Get full details and register today!

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What MPhA Is Working on Now

Southeast Minnesota Pharmacist Night Extravaganza

Register Online

Register now for an MPhA Town Hall event on Tuesday, March 29, at the Kahler Apache Hotel in Rochester, Minn.! Join us for an interactive evening and town hall as pharmacists from the 11 counties of the old MPhA Southeast District reunite.

MPhA Interim Executive Director Marsha Millonig will present a dynamic session (for the first time in Minnesota) entitled “Ten Tips for Physician Communication/Collaboration,” and President Jeff Lindoo will lead the town hall portion of the meeting where participants can share ideas, thoughts and concerns.

As a special incentive, join MPhA now for $95 for one full year! This is a savings of $200 – available only for a limited time and only for Southeast Minnesota pharmacists!

St. Cloud Area Town Hall Event

Save the date for an MPhA Town Hall event on Wednesday, April 27, in Sartell, Minn.! Come network and mingle with your colleagues while enjoying refreshments and appetizers. Earn up to 1 hour of continuing education with a refreshing debate on different approaches to provider status federally and implications for Minnesota pharmacists.

Weigh in with your opinion on the issue during the interactive discussion sections that will be sprinkled throughout the debate. Our evening will end with an open Town Hall forum. Voice your thoughts to MPhA’s leadership and staff! The Town Hall program will be presented by Minnesota Pharmacy Student Alliance (MPSA) Twin City President Anjoli Punjabi and VP of Policy Margaux Jensen. These dynamic student pharmacist leaders have developed an insightful program based on their organizational experiences.

The Minnesota Pharmacists Association is accredited by the Minnesota Board of Pharmacy as a provider of continuing pharmacy education.

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Minnesota News

KSTP-TV Reports on Minnesota Prescription Monitoring Program

A new KSTP-TV investigation finds the existing state law designed to protect patient and doctor privacy prevents the Minnesota Board of Pharmacy from alerting law enforcement and allowing access to the board’s prescription monitoring program. The story aired on Feb. 29.

The investigation found Minnesota has one of the most restrictive monitoring programs in the country; this at a time when prescription drug overdoses are killing more Minnesotans than heroin. More than 960 people have died from prescription drug overdoses since the state’s monitoring program began, according to state health officials.

Dr. Cody Wiberg, the executive director of the Board of Pharmacy, acknowledged investigators may not be able to access important evidence, and says it would be beneficial to be able to alert law enforcement in the most “egregious” cases. For example, Wiberg says a doctor shopper has avoided detection for months while visiting more than a hundred prescribers and “dozens and dozens” of pharmacies in Minnesota and surrounding states.

Yet the board has not recommended that state lawmakers loosen the restrictive privacy laws. “The board itself has not addressed if law enforcement should have direct access at this point,” Wiberg said.

Watch/read the full report

MPSA General Meeting: Residency Roundtables

The Minnesota Pharmacy Student Alliance (MPSA) will hold a general meeting on Thursday, March 10, from 12:15 to 1:15 pm.

There will be three rooms with local residency directors and residents divided into Health-System Residencies, Ambulatory Care Residencies and Industry/Managed Care Fellowships/Residencies! Each group of residencies will be in a different room. You have the opportunity to rotate through and speak with every program in one room in a small group setting!
PD1s and PD2s: This is a perfect opportunity for you to learn what the different residency programs are looking for in a residency candidate and whether pursuing a residency would be right for you.

PD3s: This is a great opportunity for you to connect witsh local residents and residency directors and get some insight on the application process before you begin to apply for residencies next fall/winter.

Please sign up here for ONE room that you are interested in! Space is limited in each room! Deadline to sign up is Monday, March 7, at 11:59 pm.

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National News

U.S. Reps Urge Transparency in Generic Drug Pricing, Payments

From National Community Pharmacists Association: U.S. Reps. Doug Collins (R-Ga.) and Dave Loebsack (D-Iowa), who are the original sponsors of the MAC Transparency Act (H.R. 244), were joined by 14 other members of Congress in a letter to the chairs and ranking members of the U.S. House Energy and Commerce, Ways and Means, and Armed Services committees urging greater transparency in generic prescription drug reimbursements for governmental health programs.

NCPA thanks Representatives Collins and Loebsack for their continued leadership, and their 14 congressional colleagues for their strong support in pushing for their bipartisan, common-sense solution to increase transparency into generic prescription drug pricing and reimbursement rates. The letter explains how CMS has begun implementing transparency provisions similar to H.R. 244 this year, so there is nothing unprecedented in this type of request. Furthermore, the letter also calls attention to a new, but related issue that needs to examined — direct and indirect remuneration (DIR) fees. The additional bipartisan members who signed the letter are (in alphabetical order) Brian Babin (R-Texas), Lou Barletta (R-Pa.), Rod Blum (R-Iowa), Jim Bridenstine (R-Okla.), Buddy Carter (R-Ga.), Rick Crawford (R-Ark.), Sam Farr (D-Calif.), Walter Jones (R-N.C.), Steve King (R-Iowa), Steven Palazzo (R-Miss.), David Rouzer (R-N.C.), Austin Scott (R-Ga.), Peter Visclosky (D-Ind.), and Peter Welch (D-Vt.).

NCPA Offers Recommendations for Nation’s Drug Abuse Problem

From National Community Pharmacists Association: NCPA has endorsed a range of solutions to the prescription drug abuse epidemic and asked lawmakers to revise an overly restrictive "lock-in pharmacy" proposal limiting Medicare beneficiary access, in comments submitted to the Senate Finance Committee, which held a hearing entitled, "Examining the Opioid Epidemic: Challenges and Opportunities.”

To help reduce prescription drug abuse, NCPA supports expanded access to naloxone; enhanced prescription drug monitoring programs; increased prescriber education; and more appropriate use of Risk Evaluation and Mitigation Strategies (REMS). NCPA is pleased to note that Medicare has recently achieved significant progress tackling prescription drug abuse, as CMS just announced a 26 percent decrease from 2011 to 2014 of Medicare Part D beneficiaries identified as potential opioid over utilizers.

In related news, NCPA believes that proposed legislation (S. 1913) to establish a Medicare "lock-in pharmacy" system limiting patient access to physicians and community pharmacies needs a number of key edits to ensure that it would be a coordinated and even-handed program. NCPA has been in constant communication with the bill sponsors, advocating that Medicare officials should administer the effort, rather than prescription drug plan sponsors, which may have a vested financial interest in steering beneficiaries to a particular pharmacy. The Senate is moving to consider the Comprehensive Addiction and Recovery Act (CARA), which would redirect existing federal resources to opioid abuse treatment and prevention programs, which could include S. 1913 as an amendment.

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Did You Know?

Flu Hospitalization Rates Climbing in Minnesota

The 2015-2016 Minnesota flu season has been milder than in previous years — however, the flu is now considered to be widespread across the state. For the week ending Feb. 20, 72 hospitalizations were reported, compared with 44 hospitalizations the previous week. It is not too late to vaccinate! Remind your patients that the flu vaccine is still available. Read the full weekly report from the Minnesota Department of Health.

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