Message from Peter Wolfgram, RPh: Update on DC Trip!

Fellow Pharmacists, Managers, and Owners

After a trip to Washington, DC in September and again in December to meet with Senator Baucus and staff, I have some important information to share with you.

September in DC was a hopeful time with the introduction of SB1951 in August and now being scored by the budget office. All bills introduced in congress must be scored as to how much this will cost the taxpayer. Those bills that have a cost associated with them must be offset by funds from some source in an attempt to keep the budget neutral. SB1951 corrected definitions in the Deficit Reduction Act as to what constituted a Retail Pharmacy and a Wholesaler. It also changed how AMP data is calculated and how the FUL is determined. It was taking an exceptionally long time to be scored and nobody knew why. The Prompt Pay bill is budget neutral so it does not have to be scored. Senator Baucus and staff were excited and very hopeful about this legislation. Representative Frank Pallone (NJ) introduced the same legislation in the house so pharmacy seemed to be in a fairly good position. Many senators and representatives signed on to these bills.

November was a time of uncertainty in DC. CMS made rumblings that they would begin publishing preliminary AMP data on a website beginning mid December. With this in mind and the lack of movement on any pharmacy legislation forced the NCPAS and NACDS to file a law suit in the DC courts to correct the inaccurate definitions and calculations of the DRA. After the lawsuit was filed, the above organizations also ask the court for an injunction to prevent the enactment of the AMP portion of the DRA saying that the enactment will cause irreparable harm to the pharmacy profession, retail pharmacies, and patient access.

December in DC is not all of good cheer. The good news is that the prompt pay bill will most likely be passed but will not really take effect until January of 2009. The PBMs whined and complained that it will take so much time to rewrite software and redo their computer systems. This I do not understand as we in Montana were paid every week by Medicaid with no extra time need to retool and no complaining on how much it will cost. Prompt pay will be coming to those of us still in business in 2009. AMP legislation is another story. Dead would be the correct term. While meeting with Senator Baucus and David Schwartz on December 5, the senator received an email memo addressed to the Senate Finance Committee from Mike Leavitt, head of HHS, stating that the Bush Administration wanted no changes to any part of Medicare Part D. Any changes would be met with the veto pen. Senator Baucus was visibly upset and let it be known to those of us present what he thought of the memo and the Bush Administration. He was not nice about it. Senator Grassley, the ranking Republican member had been making rumblings that nothing should be done about the DRA and AMP until we have more data on how this will affect pharmacy and patient access. This and the HHS memo have pretty much killed any AMP legislation this year. Senator Baucus and staff will be working on correcting the terms in DRA and asking for a 12 month delay in the implementation of the AMP and FUL changes. During this time the manufactures and wholesalers will submit data monthly and the AMP and FULs will be calculated but payments to pharmacies will not be tied to them. If this is successful then we have a 1 year reprieve. If not, then our last hope is the lawsuit and injunction. It is the administrations contention that pharmacists are overpaid and that there are way too many pharmacies in the country. With the enactment of the DRA, the marketplace will determine how many pharmacies will be left. Those pharmacies that are big enough and with the least amount of Medicaid will survive. The small independent pharmacies and small chains will be squeezed out of existence and the rural and inner city patient will suffer with lack of pharmaceutical services. The Bush Administration could care less.
The above information and views are personal observations do not necessarily represent the MPA, NCPA, nor the NACDS. Additional information can be obtained from Peter Wolfgram RPh, Belgrade, MT. Contact me at 406-388-0333 or Pwolfgram@bungalowdrug.com. I am available to meet in person with groups anywhere in Montana or northern Wyoming


Thanks for the update Peter!