December Legislative Update
OPA Fights Medicaid Cuts, State Board Rules HearingKelly Vyzral, Director of Government Affairs
OPA Fights Medicaid Cuts
Thanks to everyone who responded so quickly to our urgent e-mail request to phone your Congressman and Senator concerning the Medicaid Reform proposal. The Senate passed the proposal which would change Medicaid reimbursement from Average Wholesale Price (AWP) to Average Manufacturers Price (AMP) as benchmark for Medicaid prescription drug reimbursement. The AMP represents manufacturers' costs, not actual purchasing costs for community pharmacies. It includes prices charged to mail order vendors, as well as discounts and rebates provided to other purchasers that are not available to community pharmacies. The Senate vote on the bill was 52-47. On the Senate floor, Ohio Sen. George Voinovich questioned the severe cut-backs to pharmacy, and Sen. Mike Dewine voted against the measure all together. Initially, the House of Representatives did not have a sufficient number of votes to pass the Budget Reconciliation Bill containing the devastating Medicaid Reform proposal. The bill was pulled from the calendar, but later passed. The Senate and House versions now need to be reconciled. We still need you to continue calling your Congressmen to inform them of the effect of this legislation on your practice.
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State Board Rules Hearing
OPA recently testified at the Board of Pharmacy public hearing on the following rules.
4729-9-11 would allow a board-approved delivery system to be utilized when a pharmacy is closed. OPA adamantly opposes allowing automated dispensing machines to dispense drugs without a pharmacist present. OPA encourages pharmacists to always discuss new prescriptions with patients, and to take extra time with refills where patients commonly are noncompliant. We were successful in having this pulled from the schedule. It will be refiled to read that an automated drug delivery system can be used only when the pharmacy is open and a pharmacist is onsite.
4729-37-04 requires pharmacists to indicate the method of payment for each prescription picked up, i.e., private pay (cash), Medicaid, Medicare, commercial PBM, insurance, major medical, or workers' compensation. OPA testified against this language because it is difficult to separate payment method out of the information that is collected, and could require more expensive upgrades to computer systems. Apparently this language is coming down from the federal level and will soon be required.
4729-37-06 specifies the format that wholesalers must use for information to be transmitted to the Board of Pharmacy for the drug database. The Board of Pharmacy agreed with OPA that the transmission should be done automatically rather than manually by a pharmacist.
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 firstname.lastname@example.org.
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