June Legislative UpdateKelly Vyzral, Director of Government Affairs
OPA Members go to Washington
Several members of the Ohio Pharmacists Association traveled to Washington, D.C., May 1-3, 2005, for the National Community Pharmacists Association?s (NCPA) 37th Annual Conference on National Legislation and Government Affairs.
The Legislative Conference provided community pharmacists with the opportunity to learn about the issues that affect their pharmacy practices and their patients, and to take action by lobbying their Congressional delegations about those issues.
The target legislation for this year?s meeting was H.R.1671, Community Pharmacy Fairness Act, sponsored by Rep. Weiner (D-NY) and Rep. Moran (R-KS). This legislation would allow independent pharmacists the right to negotiate with pharmacy benefit managers (PBMs). It would grant independent community pharmacies, defined as ?not publicly held? corporations, the right to collectively negotiate the terms of third-party contracts with health plans and PBMs.
Cheers to the OPA members who attended the conference and walked to Capitol Hill to discuss this issue with the Ohio delegation. Rep. Paul Gillmor came on as a cosponsor of H.R. 1671, due purely to their efforts.
The Senate version of the budget bill was released on May 25. Please go to the OPA website, www.ohiopharmacists.org, to find out the latest information as the bill moves through the Conference Committee and on to the Governor for his signature. There are a number of significant additions to the budget that are of interest to pharmacy.
First, the legislation now requires Medicaid to update both brand and generic prices weekly. Medi-caid currently updates prices only once a month, which causes financial hardship whenever a drug increases in cost. We will work diligently to keep this language in the bill in the Conference Committee, and will work to help the Governor understand the reasonableness of the issue, so it does not get vetoed.
Pharmacists are also helped by a provision that lets a pharmacy deny service to a Medicaid patient in certain instances. Medicaid is proposing to implement a copay on the purchase of Medicaid prescriptions. However, federal law requires you to dispense a prescription to a patient, even if he/she does not have the copay. This is a huge problem, in that a lost $3 copay will remove any profit from many prescriptions. In New York, for instance, only 20 percent of patients pay their copays. The budget bill contains some important language that will at least help. If your normal business decision is to deny service to patients who owe you a debt, then you can deny the Medicaid patient service, after he/she does not pay a copay. Yes, you will lose the one copay, but you will not be on the hook in the future. It is critical that the Conference Committee keep this common-sense language in the legislation.
Another important addition to the bill is the requirement that physicians use ?step therapy? when treating Medicaid patients. The basic concept is that the physician shall use the least expensive product first in treating illnesses, when the product achieves the same clinical outcome. For instance, the latest research demonstrates that newly-diagnosed hypertensives can often be controlled with the older generic diuretic medications. Obviously, these products are much less expensive than the drugs being advertised on TV each night, so physicians will be required to utilize these medications first. This program should save the state millions of dollars.
The revised bill also allows Ohio to join with other states to create what is called a multi-state purchasing pool. This allows Ohio to try to collect larger rebates for drugs dispensed. It also requires Medicaid to study the formation of an ?intrastate? drug purchasing program for buying drugs for Medicaid, workers compensation, and other state programs. Again, the intent is to try to collect rebates for these medications. However,OPA will be working closely with the legislators to be sure that this does not become legislation for importation of medications from Canada, or a method to reduce competition in pharmacy through use of one chain or mail order program.
The bill also adds one more pharmacist to the Pharmacy and Therapeutics Committee within the Department of Job and Family Services (ODJFS), bringing the total to three pharmacists. We strongly support the addition of more pharmacist expertise to this group.
An interesting part of the bill is a requirement that the top 10 Medicaid prescribers be required to electronically prescribe. As you know, the systems are not totally ready for physicians to electronically prescribe, and for all pharmacies to accept those electronic prescriptions. We will be working with the legislature to understand this. However, there is strong national and state pressure to get electronic prescribing in place, and this would do it.
By the time you read this, the legislation will be passed, and we will be working on implementation. Thanks for working with us to shape this important legislation.
SB 18: Drug Compounding. This bill, which allows for non-patient specific compounding, was signed by the Governor May 18, 2005. It becomes effective 90 days later.
If you have any questions or comments about the issues mentioned in this article, please contact Kelly Vyzral, Director of Government Affairs at 614.586.1497 or email@example.com.
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