Government Affairs Update - Week Ending March 26, 2010
National Community Pharmacists Association (NCPA)
Health Care Reform—DONE AND DONE!
This past Tuesday March 23rd, President Obama signed into law the Patient Protection and Affordable Care Act, after it cleared the House last Sunday night. This is the same health care reform bill that cleared the Senate on December 24th, 2009. This legislation was signed into law n Tuesday, March 23rd by President Obama.
The House also passed H.R. 4872, the Health Care Reconciliation Bill, which makes amendments to H.R. 3590 (the Senate Health Care Reform bill). These changes had no impact on the significant pharmacy provisions in the health care reform bill. The Senate and House resolved all problems with the reconciliation language this week so the legislative work is completed but we still have a long road ahead with implementation.
A summary of the major provisions of the new law that affect pharmacy are attached in a separate email. Over the next months (and years), NCPA will be working hard to assure that the regulatory agencies – notably HHS and CMS – implements these provisions consistent with Congressional intent. We have also attached a summary of the new Medicare Part D donut hole provisions. Medicare beneficiaries may already be asking pharmacies how this new program is going to work.
Don Berwick, M.D.. to be CMS Administrator: President Obama is to nominate Donald Berwick, MD, MPP to become Administrator of CMS. Dr. Berwick is a professor in the Department of Health Policy and Management in the Harvard School of Public Health. He is also President and CEO at the Institute for HealthCare Improvement. His nomination would have to be confirmed by the U.S. Senate.
NCPDP’s Short Cycle Dispensing Discussion Panel: The National Council for Prescription Drug Programs’ Short Cycle Dispensing Discussion Panel was held on March 19th. Representatives from industry, including pharmacy, vendors/suppliers, and plans/PBMs, addressed the new legislation intended to reduce medication waste, diversion, and costs in the LTC setting. Topics of discussion included: costs associated with the technology of central and remote dispensing; differences by state, insurance, and facility type; post consumption versus prospective billing; and cycle versus demand filling. Each of the panels stressed that CMS needed to promulgate clearly defined rules and regulations allowing for consistency in medication dispensing and payment.
Senate Special Committee on Aging Nurse-as-Agent Listening Session: Senator Herb Kohl (D-WI) chaired the Senate Special Committee on Aging’s listening session on March 24th titled: “The War on Drugs Meets the War on Pain: Nursing Home Patients Caught in the Crossfire.” DEA stated it has the authority to create a new category of registration for state licensed long-term care facilities to allow nurses to act as agents of the physicians they serve. Currently, nurses are not considered agents of the physician in the long term care setting, and all changes in Schedule II-V controlled substances must be communicated directly from the physician to the pharmacist resulting in long wait times for residents’ pain medications. Registering these facilities would allow nurses to take chart orders and send them directly to pharmacists as is currently the case in hospitals. DEA indicated that states would have to allow LTC facilities to be first registered by the state boards of pharmacy before they could obtain a DEA license. NCPA will continue to work with all interested parties to insure this issue is resolved expeditiously. NCPA’s comments to the Senate Special Aging Committee will soon be found on the new LTC link under the Advocacy section of the website located at: http://www.ncpanet.org/advocacy/index.php. The full Senate listening session can be viewed at: http://aging.senate.gov/hearing_detail.cfm?id=323367&.
DEA Regulation on E-Rx for Controlled Substances: The long awaited DEA rule related to electronic prescribing for controlled substances has been released. The Interim Final Rule with Request for Comment is entitled “Electronic Prescriptions for Controlled Substances” and will be published in the Federal Register on March 31, 2010. The rule will become effective June 1, 2010. NCPA is reviewing the rule and will be. |
