Please visit In the Spotlight to read very clear and concise summaries on these two very vital bills, as well as other vital bills regarding CMS and AMP!
Special thanks to APhA, Thomas R. Clark, RPh, MHS Director of Policy & AdvocacyAmerican Society of Consultant Pharmacists, and Jim Smith, Executive Director of Montana Pharmacy Association for breaking these bills down and/or sharing them with us!
Thursday, August 16, 2007
Sunday, August 12, 2007
Act Now..S.1954; S.1951 and H.R.1474 and H.R.1340
Finally…Hope, but a lot of work must be done before our goals of protecting pharmacy and preserving patient access to community pharmacies is accomplished.
Community pharmacies fill the void in health care by offering special services and medication packaging to further our health care system. Without our services and extra time providing theses services, many patients would be noncompliant and/or uneducated about the medication they or their loved one take; not to mention all pharmacists are the “first line against pharmaceutical and prescribing errors”. The list of services community pharmacies provide is numerous and is vital to our community, but unfortunately these services are being overlooked by our government wrapping all pharmacies into the same category with the mind set that all pharmacies, including PBM mail order pharmacies, have the same costs, services, and reimbursements. As we know this is clearly NOT TRUE!
Thanks to our very own Senator Baucus and Iowa’s Senator Grassley, they are putting their best foot forward by introducing the Pharmacy Access improvement Act (PhAIM) of 2007 (S.1954). This bill provides common sense fixes to the Medicare PartD program including 14 day electronic fund transfer for prompt reimbursement and paper claims within 30 days. Currently pharmacies are lucky to get paid by PBM’s in 30 to 60 days with the average pharmacy having to borrow $70,000 to hundreds of thousands of dollars just to make ends meet. In addition, PBM’s get paid monthly IN ADVANCE by Medicare, yet PBM’s “enjoy a considerable interest-earning float on tax-payers dollars intended to reimburse community pharmacies for serving their patients” said Roberts, RPh, of NCPA. During the year 2006, 1,152 community pharmacies were ‘shuttered or sold’ according to the NCPA-Pfizer Digest. The only thing new introduced into the pharmacy system was Medicare Part D, otherwise, community pharmacies would have continued their steady growth rate.
Similarly, H.R.1474 labeled the “Fair and Speed Treatment of Medicare Prescription Drug Claims” is making headway with a total of 190 bipartisan supporters. Please ask Congressman Rehberg to support H.R.1474 (GrizRPh News April 13th) as well as H.R.3140 (GrizRph News July 26th). Both these bills are similar to bills in the Senate, but we truly need to give every thing we’ve got to make this work since CMS has already made there statements to NOT CHANGE reimbursement which will be devastating to our pharmacies if these or similar bills do not pass. Rehberg’s staff is aware of these bills but they need to here from us…the pharmacists, technicians, and pharmacy owners in the trenches who see the devastating affects of Medicare and soon to be Medicaid on a daily basis with low and slow reimbursement. It just takes a few minutes to pick up the phone or email...yes, your opinion matters greatly!!! In numbers, we can stop these devastating affects to pharmacy!
In addition, Senator Baucus also introduced AMP fix legislation “The Fair Medicaid Drug Payment Act” (S.1951) which may save all our hides if implemented!!! Without this bill and other current pharmacy legislation, community pharmacies will be paid by Medicaid, on average, 36% below acquisition cost for medications, which will lead community pharmacies to eventually not participate by turning their backs on Medicaid patients, or close their doors. The Deficit Reduction Act of 2005 is suppose to decrease healthcare costs and national deficit not increase deficit and decrease patient healthcare, compliance, and pharmacy availability! Senator Baucus’s AMP fix focuses on a “300% reimbursement of AMP by COMMUNITY PHARMACIES on a nationwide basis and that FUL (Federal Upper Limits) do not vary monthly upon rebates, discounts or other pricing practices as well as the removal of mail order transactions from its calculations. Please support your pharmacy, and paycheck, by (1) thanking Senator Baucus for both S.1954 and S.1951. (2) Please also ask Senator Testor to Co-Sponsor S.1954 and other Senate pharmacy bills and (3) Please ask Congessman Rehberg to Co-Sponsor H.R.1474 (GrizRPh News April 13th) and H.R.3140 (GrizRPhNews July 26th). Please do your part and phone or email…we can protect pharmacy by standing up and shouting in one voice OR sit back and watch the devastating affects take place! Your choice will matter!!! Thank you for supporting Community Pharmacies as well as ALL PHARMACIES nationwide by writing to your Representatives! Please visit http://www.rxmt.org/ for a concise summary of these bills!
Thank you,
Eric Shields, PharmD
GrizRPh.com
Community pharmacies fill the void in health care by offering special services and medication packaging to further our health care system. Without our services and extra time providing theses services, many patients would be noncompliant and/or uneducated about the medication they or their loved one take; not to mention all pharmacists are the “first line against pharmaceutical and prescribing errors”. The list of services community pharmacies provide is numerous and is vital to our community, but unfortunately these services are being overlooked by our government wrapping all pharmacies into the same category with the mind set that all pharmacies, including PBM mail order pharmacies, have the same costs, services, and reimbursements. As we know this is clearly NOT TRUE!
Thanks to our very own Senator Baucus and Iowa’s Senator Grassley, they are putting their best foot forward by introducing the Pharmacy Access improvement Act (PhAIM) of 2007 (S.1954). This bill provides common sense fixes to the Medicare PartD program including 14 day electronic fund transfer for prompt reimbursement and paper claims within 30 days. Currently pharmacies are lucky to get paid by PBM’s in 30 to 60 days with the average pharmacy having to borrow $70,000 to hundreds of thousands of dollars just to make ends meet. In addition, PBM’s get paid monthly IN ADVANCE by Medicare, yet PBM’s “enjoy a considerable interest-earning float on tax-payers dollars intended to reimburse community pharmacies for serving their patients” said Roberts, RPh, of NCPA. During the year 2006, 1,152 community pharmacies were ‘shuttered or sold’ according to the NCPA-Pfizer Digest. The only thing new introduced into the pharmacy system was Medicare Part D, otherwise, community pharmacies would have continued their steady growth rate.
Similarly, H.R.1474 labeled the “Fair and Speed Treatment of Medicare Prescription Drug Claims” is making headway with a total of 190 bipartisan supporters. Please ask Congressman Rehberg to support H.R.1474 (GrizRPh News April 13th) as well as H.R.3140 (GrizRph News July 26th). Both these bills are similar to bills in the Senate, but we truly need to give every thing we’ve got to make this work since CMS has already made there statements to NOT CHANGE reimbursement which will be devastating to our pharmacies if these or similar bills do not pass. Rehberg’s staff is aware of these bills but they need to here from us…the pharmacists, technicians, and pharmacy owners in the trenches who see the devastating affects of Medicare and soon to be Medicaid on a daily basis with low and slow reimbursement. It just takes a few minutes to pick up the phone or email...yes, your opinion matters greatly!!! In numbers, we can stop these devastating affects to pharmacy!
In addition, Senator Baucus also introduced AMP fix legislation “The Fair Medicaid Drug Payment Act” (S.1951) which may save all our hides if implemented!!! Without this bill and other current pharmacy legislation, community pharmacies will be paid by Medicaid, on average, 36% below acquisition cost for medications, which will lead community pharmacies to eventually not participate by turning their backs on Medicaid patients, or close their doors. The Deficit Reduction Act of 2005 is suppose to decrease healthcare costs and national deficit not increase deficit and decrease patient healthcare, compliance, and pharmacy availability! Senator Baucus’s AMP fix focuses on a “300% reimbursement of AMP by COMMUNITY PHARMACIES on a nationwide basis and that FUL (Federal Upper Limits) do not vary monthly upon rebates, discounts or other pricing practices as well as the removal of mail order transactions from its calculations. Please support your pharmacy, and paycheck, by (1) thanking Senator Baucus for both S.1954 and S.1951. (2) Please also ask Senator Testor to Co-Sponsor S.1954 and other Senate pharmacy bills and (3) Please ask Congessman Rehberg to Co-Sponsor H.R.1474 (GrizRPh News April 13th) and H.R.3140 (GrizRPhNews July 26th). Please do your part and phone or email…we can protect pharmacy by standing up and shouting in one voice OR sit back and watch the devastating affects take place! Your choice will matter!!! Thank you for supporting Community Pharmacies as well as ALL PHARMACIES nationwide by writing to your Representatives! Please visit http://www.rxmt.org/ for a concise summary of these bills!
Thank you,
Eric Shields, PharmD
GrizRPh.com
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