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NCPA General Meeting October 29 th , 2007 HLS G04 NCPA Exec Officers Dustin Rewinkel - President DustinRewinkel@creighton.edu Andy Kampfe - VP AndyKampfe@creighton.edu Julia Rhodes - Secretary JuliaRhodes@creighton.edu Andy Bath - Treasurer AndrewBath@creighton.edu

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ncpa general meeting

NCPA General Meeting

October 29th, 2007

HLS G04

ncpa exec officers
NCPA Exec Officers
  • Dustin Rewinkel - President
    • DustinRewinkel@creighton.edu
  • Andy Kampfe - VP
    • AndyKampfe@creighton.edu
  • Julia Rhodes - Secretary
    • JuliaRhodes@creighton.edu
  • Andy Bath - Treasurer
    • AndrewBath@creighton.edu
  • Stephanie Morgan – PHPSG Rep
    • StephanieMorgan@creighton.edu
list of sessions
List of Sessions
  • Get DME Accredited and Bid
  • ROI: Convenient Care Clinics
  • Snapshot of Profitable Niches
    • Foot Care Program
    • Pain Management
    • Travel Immunizations
    • Nutrition
    • Obesity
    • Veterinary Compounding
    • Durable Medical Equipment
    • MTM
  • Pharmacy Valuations and Exit Strategies
list of sessions10
List of Sessions
  • Models of Ownership
  • Medication Therapy Management
  • Issues that Affect the Pharmacy Profession
  • Opportunities in Medicare Part D
  • Embracing Pharmacy Professional Services for Business Survival
  • Survival Spanish for Pharmacists
t shirt sales
T-shirt Sales
  • $12/t-shirt
    • $11/shirt if 3 or more ordered
  • Available in gray, royal blue or navy
phpsg update
PHPSG Update
  • Dress code passed
    • No pajama or sweat pants
    • No hats or caps
    • All visible tattoos must be covered
    • All visible body piercings other than ears are not permitted during classroom hours
    • Waiting for faculty approval
    • Those consistently noncompliant may face Professional Behavior Citation

PHPSG Rep – Stephanie Morgan

stephaniemorgan@creighton.edu

current legislation
Current Legislation
  • Medicaid – defining AMP
  • Medicare Part D – prompt payment and co-branding
  • PBMs – contain their assault on Community Pharmacy
medicaid
Medicaid
  • AMP is the new baseline for generic drugs reimbursements in Medicaid
  • GAO report stated that pharmacies would be reimbursed 36% below their average retail pharmacy acquisition cost
  • AMP-based FUL is below pharmacy acquisition cost for 19 of the 25 most prescribed generics
medicaid16
Medicaid
  • AMP must reflect community pharmacies actual acquisition cost
  • AMP must exclude discounts not available to retail pharmacy, such as mail order discounts and PBM redates
  • AMP must be reported frequently, with oversight and review
amp legislation
AMP Legislation
  • H.R. 3140, Saving Our Community Pharmacies Act of 2007
  • S. 1951, Fair Medicaid Drug Payment Act of 2007 (H.R. 3700)
h r 3140
H.R. 3140
  • The new benchmark would be Retail Acquisition Cost (RAC)
  • RAC is the median price for each drug based on a quarterly survey of actual invoices subject to audit from a 5% representative sample of pharmacies nationwide
  • A FUL based on RAC will allow states to pay pharmacies accurately and preserve patient access
  • Require states to increase their use of cost-effective generic drugs by 1-3% each year
s 1951
S. 1951
  • Retains AMP as the benchmark but would use the weighted average price (rather than lowest) available to retail pharmacy
  • Excludes special prices extended to mail order pharmacies
  • Increases payment rate from 250% of AMP to 300%
  • Requires prior auth for coverage of a more-expensive brand name drug when a cheaper generic is available
medicare part d prompt pay
Medicare Part D – Prompt Pay
  • Slow reimbursement
  • Low reimbursement
  • No electronic direct deposit
  • No definition of “clean claim”
medicare part d legislation
Medicare Part D Legislation
  • H.R. 1474, the Fair and Speedy Treatment (FAST) of Medicare Prescription Drug Claims Act
  • S. 1954, the Pharmacy Access Improvement Act
h r 1474 s 1954
H.R. 1474 & S. 1954
  • Requires PDPs to pay within 14 days by electronic transfer
  • Addresses co-branding in a more thorough manner than CMS does
  • Spells out terms for “clean claims”
slide23
PBMs
  • Take it or Leave it Contracts
  • Shrinking and shifting formularies
  • Pre-authorizations and formulary-restricted prescriptions
  • 90-day prescriptions only through PBM mail order
h r 971
H.R. 971
  • Allows independent pharmacies, defined as pharmacies not owned or operated by a publicly traded company, the same leverage that much larger chains enjoy when negotiating their Medicare Part D and other third-party contracts
next meeting
Next Meeting
  • Congressman Lee Terry (NE-3rd)
    • How to get to know your congressman
      • Which form of contact is the most effective (letter, visit, email, phone call)?
      • What is the best way to petition your congressman?
websites
Websites
  • Chapter Website
    • pharmacy.creighton.edu/ncpa
  • National Website
    • www.ncpanet.org