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NCPA General Meeting October 29 th , 2007 HLS G04 NCPA Exec Officers Dustin Rewinkel - President [email protected] Andy Kampfe - VP [email protected] Julia Rhodes - Secretary [email protected] Andy Bath - Treasurer [email protected]

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NCPA General Meeting

October 29th, 2007


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NCPA Exec Officers

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NCPA Annual ConventionOctober 13-17, 2007

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View from 3 Discussionrd floor of Annual Convention Center

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List of Sessions Discussion

  • 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

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List of Sessions Discussion

  • 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

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T-shirt Sales Discussion

  • $12/t-shirt

    • $11/shirt if 3 or more ordered

  • Available in gray, royal blue or navy

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PHPSG Update Discussion

  • 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

      [email protected]

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Current Legislation Discussion

  • Medicaid – defining AMP

  • Medicare Part D – prompt payment and co-branding

  • PBMs – contain their assault on Community Pharmacy

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Medicaid Discussion

  • 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

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Medicaid Discussion

  • 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

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AMP Legislation Discussion

  • H.R. 3140, Saving Our Community Pharmacies Act of 2007

  • S. 1951, Fair Medicaid Drug Payment Act of 2007 (H.R. 3700)

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H.R. 3140 Discussion

  • 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

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S. 1951 Discussion

  • 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

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Medicare Part D – Prompt Pay Discussion

  • Slow reimbursement

  • Low reimbursement

  • No electronic direct deposit

  • No definition of “clean claim”

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Medicare Part D Legislation Discussion

  • H.R. 1474, the Fair and Speedy Treatment (FAST) of Medicare Prescription Drug Claims Act

  • S. 1954, the Pharmacy Access Improvement Act

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H.R. 1474 & S. 1954 Discussion

  • 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”

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PBMs Discussion

  • Take it or Leave it Contracts

  • Shrinking and shifting formularies

  • Pre-authorizations and formulary-restricted prescriptions

  • 90-day prescriptions only through PBM mail order

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H.R. 971 Discussion

  • 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

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Next Meeting Discussion

  • 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?

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Websites Discussion

  • Chapter Website


  • National Website